The Effect of Intrabdominal Pressure in Patients Undergoing Bariatric Surgery
Condition: Intraabdominal Pressure; Bariatrik Surgery
Study type: Observational [Patient Registry]

Summary: 
      Morbid obesity is a global health problem that concerns the whole world. It is associated
      with many concomitant health problems such as diabetes, hypertension, congestive heart
      failure. There are publications showing that morbid obesity increases chronic intra-abdominal
      pressure, and it has been investigated that this chronic pressure exposure may cause many
      comorbidities accompanying obesity. When we reviewed the literature, we could not find an
      adequate study showing the effects of obesity-related increased intra-abdominal pressure on
      postoperative mortality and morbidity.

      The aim of this study is to show the effect of obesity-related intra-abdominal pressure on
      postoperative mortality and morbidity.
    

Detailed description: 
      Our study included 80 female patients with ASA (American Society of Anesthesia) II-III, who
      were planned to undergo laparoscopic sleeve gasterctomy or bypass operation after ethics
      committee approval. BMI (body Mass Index)> 35, 18-65 years old, female, non-smoker, not
      undergoing revisional bariatric surgery, and not undergoing major abdominal surgery before
      were included. Propofol 2mg/kg, Remifentanil 1mcg/kg, and rocuronium 0.6mg/kg were
      administered to the patients by monitoring with ECG, pulse oximetry and non-invasive blood
      pressure measurement, which we performed in bariatric surgery patients in our clinic. The
      corrected weights of the patients were used in dose calculations as recommended by the
      Society of Bariatric Anesthesia. Immediately after intubation, while the patient was lying in
      the supine position, intra-abdominal measurement was taken from the bladder catheter and
      recorded. Then, after the surgical site antisepsis, when the trocar required for the
      operation was placed by the general surgeon, another measurement was made from the trocar
      port. The measurements were recorded. Arterial blood pressure, heart rate, oxygen saturation,
      maintenance fluids, and complications were recorded every 5 minutes intraoperatively.
      Postoperative hospital stay of the patients, urine output, onset time of bowel movements, and
      all complications were recorded.

      SPSS 21.0 computer program was used for statistical analysis. The normality of the
      distribution of the data was evaluated with the Kolmogorov-Smirnov test. Intergroup data will
      be evaluated by one-way ANOVA, and in-group data will be evaluated with repetitive ANOVA
      test. Chi-square was used in the analysis of ordinal data. P < 0.05 will be considered as a
      statistically significant difference. The sample size was calculated as 80 patients at 90%
      confidence interval.
    

Intervention name(s): measurment of intraabdominal surgery
Intervention type(s): Other
Intervention description(s): Immediately after intubation, while the patient is lying in the supine position, an intra-abdominal measurement will be made from the bladder catheter and recorded. Then, after the surgical site antisepsis, when the trocar required for the operation is placed by the general surgeon, another measurement will be made from the trocar port. Measurements will be recorded.
Observational model: Case-Only
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        ASA (American Society of Anesthesia) II-III female patient who is planned to undergo
        laparoscopic sleeve gasterctomy or bypass operation will be included. BMI (body Mass
        Index)> 35, 18-60 years old, female, non-smoker