Comparison of Volume Controlled Ventilation and Autoflow-volume Controlled Ventilation in Robot-assisted Laparoscopic Radical Prostatectomy With Steep Trendelenburg Position and Pneumoperitoneum

Study Overview
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Brief Summary
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The steep trendelenburg position and pneumoperitoneum during laparoscopic surgery have the potential to cause an adverse effects on respiratory mechanics and gas exchange. Autoflow-volume controlled ventilation may improve lung compliance and reduce airway peak pressure. Therefore, the aim of this study is to evaluate whether Autoflow-volume controlled ventilation improves gas exchange and respiratory mechanics in patients undergoing robot-assisted laparoscopic radical prostatectomy.

Conditions
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Robot-assisted Laparoscopic Radical Prostatectomy Undergoing General Anesthesia

Intervention / Treatment
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* Other: Volume controlled ventilation
* Other: Autoflow-volume controlled ventilation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 1. Adult male patients scheduled for elective robot-assisted laparoscopic radical prostatectomy undergoing general anesthesia Exclusion Criteria: chronic obstructive respiratory diseases heart failure body mass index (BMI >30 kg/m2)

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Volume controlled ventilation<br>During the steep trendelenburg position and pneumoperitoneum, volume controlled ventilation will be applied with 8ml/kg (ideal body weight) and inspiration:expiration ratio (I:E) = 1:2. | Other: Volume controlled ventilation<br>* During anesthesia and surgical procedure, volume-controlled ventilation will be applied with an inspiration:expiration ratio of 1:2 and a tidal volume of 8 mL per ideal body weight (kg) without ventilatory mode change.<br>* Other names: VCV;|
| Active Comparator: Autoflow-volume controlled ventilation<br>During the steep trendelenburg position and pneumoperitoneum, Autoflow-volume controlled ventilation will be applied with 8ml/kg (ideal body weight) and inspiration:expiration ratio (I:E) = 1:2. | Other: Autoflow-volume controlled ventilation<br>* After tracheal intubation, volume-controlled ventilation will be initiated with an I:E ratio of 1:2 and a tidal volume of 8 mL per ideal body weight (kg). Immediately after CO2 pneumoperitoneum with steep Trendelenburg positioning, Autoflow-volume controlled ventilation will be applied instead of volume-controlled ventilation. Immediately after CO2 desufflation and supine positioning, volume-controlled ventilation will be applied again.<br>* Other names: Autoflow-VCV;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| arterial oxygen tension (PaO2) | Arterial oxygen tension (PaO2) obtained from arterial blood gas analysis | 30 minutes after steep trendelenburg position and pneumoperitoneum. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The peak inspiratory pressure | The peak inspiratory pressure during mechanical ventilation with endotracheal intubation under general anesthesia | 10 minutes after anesthesia induction, 30 and 60 minutes after steep trendelenburg position and pneumoperitoneum, and 10 minutes after supine position and CO2 desufflation. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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robot-assisted laparoscopic radical prostatectomy, Autoflow, trendelenburg position, pneumoperitoneum