Laparoscopic Sleeve Gastrectomy Research Paper

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Effects of volume controlled-equal ratio ventilation with recruitment maneuver and positive end-expiratory pressure in laparoscopic sleeve gastrectomy: a randomized controlled trial SUMMARY Background: The aim of this study was to investigate the effects of volume controlled-equal ratio ventilation (VC-ERV) on oxygenation, respiratory mechanics, and hemodynamic status during mechanical ventilation with recruitment maneuver (RM) and positive end-expiratory pressure (PEEP) in patients undergoing laparoscopic sleeve gastrectomy. Methods: Obese patients with scheduled for laparoscopic sleeve gastrectomy were randomized to receive inspiratory to expiratory ratio of 1:1 [Group VC-ERV (n: 56)] or 1:2 [Group VC-CRV (n: 55)] following tracheal intubation. …show more content…

All patients were continuously monitored for non-invasive blood pressure (NIBP), heart rate (HR), oxygen saturation (SpO2), end-tidal carbon dioxide (EtCO2), electrocardiogram (ECG) and, core body temperature. Preoxygenation was provided, at least 5 minutes, with supplemental oxygen (3 L/min) administered via a face mask during the monitoring procedure. A standardized anesthetic induction and maintenance was used and all drug dosages were calculated according to ideal body weight. General anesthesia was induced intravenously with propofol (1.5–2.5 mg/kg) and fentanyl (2 µg/kg), and tracheal intubation was facilitated with rocuronium (0.8 mg/kg) in the 30° reverse Trendelenburg position. A 20- gauge catheter was placed in the radial artery for arterial blood gas samples. Anesthesia was maintained with 2-3% sevoflurane in 50:50 oxygen and nitrous oxide and intravenous …show more content…

Respiratory rate (RR) was set to an EtCO2 between 30 and 40 mm Hg. Patients were then, randomly assigned to 1 of 2 ventilation protocols. Inspiratory-to-expiratory (I/E) time ratio was set as 1:1 and 1:2 in volume controlled-equal ratio ventilation (VC-ERV) and volume controlled-conventional ratio ventilation (VC-CRV) groups respectively. Randomization was provided using a computer-generated randomization list including 120 patients. The attending anesthesiologist was aware of the allocated group, but the data analyst, surgeon and the patients were blinded to group

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