The Effect of Ventilation Modes on Cerebral Oxymetry In Operation
Condition: Cholecystitis; Gallstone; Mechanical Ventilation Pressure High; Intraabdominal Hypertension
MeSH terms: Intra-Abdominal Hypertension; Cholecystitis; Gallstones
Study type: Interventional

Summary: 
      In laparoscopic cholecystectomy method, Insufflation of CO2 in abdominal cavity causes
      positioning of the diaphragm upwards, a decrease in lung's volume and its compliance, an
      increase in the airway resistance, mismatch between the atelectasis and the ventilation
      perfusion. Although there are numerous studies in laparoscopic surgery, only a few of them
      investigate the effects of laparoscopic surgery on the cardiopulmonary and the respiratory
      mechanics. The investigator aimed To examine the effects of pressure-controlled and
      volume-controlled ventilation modes on cerebral oximetry and blood gases in laparoscopic
      cholecystectomy operations.
    

Detailed description: 
      Since the laparoscopic methods have been introduced to the surgical operations, laparoscopic
      cholecystectomy has become the golden standard in gall bladder surgical treatments. In this
      method, carbon dioxide (CO2) pneumoperitoneum method is used to achieve the desired surgical
      and visual conditions. Alongside the advantages of the Laparoscopic cholecystectomy method
      (e.g. shortening the patient's length of stay at the hospital, minimal postoperative pain and
      rapid recovery), it has various intraabdominal pressure related systemic disadvantages .
      Insufflation of CO2 in abdominal cavity causes positioning of the diaphragm upwards, a
      decrease in lung's volume and its compliance, an increase in the airway resistance, mismatch
      between the atelectasis and the ventilation perfusion. Various ventilation strategies have
      been introduced to increase arterial oxygenation, functional residual capacity (FRC), and the
      lung compliance. Recent studies; demonstrates that pressure-controlled mechanical ventilation
      is superior to volume-controlled mechanical ventilation in providing arterial and tissue
      oxygenation.

      Although there are numerous studies in laparoscopic surgery, only a few of them investigate
      the effects of laparoscopic surgery on the cardiopulmonary and the respiratory mechanics.
      Several experimental and clinical studies describe that the cardiovascular effects of the
      high intraabdominal pressure and the CO2 insufflation is complex. In fact, the results are
      linked to the studied patients' population, the lung's position and its volume. As it is
      known in laparoscopic surgeries, the oxygenation in cerebral tissue decreases as the
      intraabdominal pressure increases. At present, bispectral index (BIS), electroencephalography
      (EEG), auditory evoke potential (AEP) (and several others) and functional NIRS (fNIRS) are
      used to measure cerebral oxygenation and anaesthetic depth. NIRS monitorisation makes use of
      the combined effects of the transmission, the reflection, the dispersion, and the absorption
      of light. It can also measure the oxygen saturation in tissues that does not have pulsatile
      circulation. The investigator aimed To examine the effects of pressure-controlled and
      volume-controlled ventilation modes on cerebral oximetry and blood gases in laparoscopic
      cholecystectomy operations.
    

Intervention name(s): mechanical ventilation modes
Intervention type(s): Device
Intervention description(s): ventilation with pressure controlled mode in laparoscopic abdominal surgery ventilation with volume controlled mode in laparoscopic abdominal surgery
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: The first group was labelled as "Group V" as they are applied with mechanical ventilation under controlled volume, and the second group was labelled as "Group P" as they are applied with mechanical
Masking: None (Open Label)
Primary purpose: Screening
Keywords: laparoscopy