Pulmonary Impacts of Anaesthetic Modalities Evaluated by Ultrasound

Study Overview
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Brief Summary
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A prospective, observational, monocentric study aimed at identifying ultrasound changes in anaesthesia on the pulmonary parenchyma after knee arthroplastic surgery using the LUS score in the preoperative, immediate post-operative (D0) and late post-operative (D1) periods.

Detailed Description
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Post-operative pulmonary complications are responsible from morbidity and mortality close to cardiovascular complications. Perioperative and post-operative respiratory changes are secondary to anaesthesia (general anaesthesia, elongated position, tidal volume) and to surgery in particular abdominal and cardiothoracic surgery. Several risk factors related to patients were identified: age, ASA score> 2, functional dependence, chronic obstructive pulmonary disease, congestive heart failure, obesity, smoking. Pulmonary ultrasound is a simple and rapid means of monitoring, widely used in resuscitation and developing in anaesthesia. The hypothesis of the study is that anaesthesia and / or ventilation is responsible for lung lesions observable by ultrasound from the recovery room, even after extra-thoracic surgeries. To do this, it will perform 3 pleuro-pulmonary ultrasound scans, preoperatively on the day of surgery, post-operatively in the recovery room and the day after surgery. LUS score will be calculated. Preoperative data (morphology, comorbidities), preoperative (ventilation, filling, position, type of anaesthesia - general anaesthesia with intubation or laryngeal mask, spinal anaesthesia- , type of surgery) and postoperative data (constants, oxygen therapy, complications) will be collected.

Official Title
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Pulmonary Impacts of Anaesthetic Modalities Evaluated by Ultrasound: A Prospective Study in Scheduled Knee Arthroplasty

Conditions
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Anesthesia

Intervention / Treatment
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* Diagnostic Test: pleuropulmonary ultrasound


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient undergoing scheduled primary knee arthroplasty : Partial knee replacement surgery Total knee replacement surgery • Type of Anaesthesia General anaesthesia with orotracheal intubation General anaesthesia with laryngeal mask Spinal anaesthesia Major Patient Oral non opposition collected after oral information of the study Exclusion Criteria: Refusal to participate Preoperative pleural pathology (pleural effusion, pleural symphysis) Pregnancy Patient under authorship or curators non-affiliation to a social security scheme

Ages Eligible for Study
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Minimum Age: 18 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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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| General anaesthesia with orotracheal intubation<br>surgery patients under general anaesthesia with orotracheal intubation | Diagnostic Test: pleuropulmonary ultrasound<br>* three pleuro-pulmonary ultrasound scans will be performed, preoperatively on the day of surgery, post-operatively in the recovery room and the day after surgery<br>|
| General anaesthesia with laryngeal mask<br>surgery patient under general anaesthesia with laryngeal mask | Diagnostic Test: pleuropulmonary ultrasound<br>* three pleuro-pulmonary ultrasound scans will be performed, preoperatively on the day of surgery, post-operatively in the recovery room and the day after surgery<br>|
| Spinal anaesthesia<br>surgery's patients under Spinal anaesthesia | Diagnostic Test: pleuropulmonary ultrasound<br>* three pleuro-pulmonary ultrasound scans will be performed, preoperatively on the day of surgery, post-operatively in the recovery room and the day after surgery<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| lung lesions by the anaesthetic and operative management after knee replacement surgery | Describe lung lesions by the anaesthetic and operative management after knee replacement surgery | 10 minutes before surgery | 
| lung lesions by the anaesthetic and operative management after knee replacement surgery | Describe lung lesions by the anaesthetic and operative management after knee replacement surgery | 10 minutes post surgery | 
| lung lesions by the anaesthetic and operative management after knee replacement surgery | Describe lung lesions by the anaesthetic and operative management after knee replacement surgery | 24hours post surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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anaesthetic modality, Lung