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Trial registered on ANZCTR
Registration number
ACTRN12615000581561
Ethics application status
Approved
Date submitted
16/05/2015
Date registered
3/06/2015
Date last updated
6/05/2016
Type of registration
Prospectively registered
Titles & IDs
Public title
Comparison of the effects of different PEEP (positive end-expiratory pressure) levels on cerebral oxygen saturation in patients undergoing laparoscopic cholecystectomy
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Scientific title
Comparison of the effects of different PEEP levels on cerebral oxygen saturation with near infrared spectroscopy during laparoscopic cholecystectomy
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Secondary ID [1]
286724
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Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
CO2 pneumoperitoneum
295087
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Cerebral oxygen saturation
295200
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Condition category
Condition code
Anaesthesiology
295337
295337
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0
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Other anaesthesiology
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Surgery
295450
295450
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0
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Surgical techniques
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
One hundred and five patients between the ages of 18-60 yr, ASA physical status I and II, scheduled to undergo routine laparoscopic cholecystectomy under general anesthesia, were studied. The patients were randomized, by using a computer-generated block randomisation, into 3 groups: Group I (n=35) with no external PEEP, Group II (n=35) with external PEEP of 5 cmH2O, Group III (n=35) with external PEEP of 10 cmH2O. Routine monitors (consisting of a pulse oximeter, 3-lead ECG and a non-invasive blood pressure cuff ) and BIS monitoring were applied. In addition to this monitoring cerebral oximeter sensors were attached to frontotemporal areas (both right and left). Fasting periods were in accordance with ASA guidelines, and no one premedicated. Anesthesia was induced with propofol (2 mg/kg) and fentanyl (1-2 microg/kg), and endotracheal intubation was facilitated using rocuronium. After induction, volume- controlled mechanical ventilation (tidal volume adjusted to 8 mL/kg with no application of PEEP in Group I, 5 cmH2O in Group II, 10 cmH2O in Group III and respiratory rates were adjusted to achieve an end-tidal carbon dioxide of 30 to 35 mmHg) was initiated. All patients were ventilated with the same anesthetic machine. Anaesthesia was maintained using sevoflurane 1–2% in an oxygen / air mixture and remifentanil (0,25 microg/kg/min) accompanied by BIS monitoring. The CO2 pneumoperitoneum (PP) was introduced with a closed Veress needle technique, and the intraa-bdominal insufflation pressure was limited to 10-12 mmHg. After introduction of the four trocars and insufflation of CO2, the patient was placed in the reverse Trendelenburg position, using up to 30 degree of head-up tilt. HR, MBP, oxygen saturation (SpO2) and rSO2 values were continuously recorded from awake status to tracheal extubation (basal, after induction, after intubation, immediately after pneumoperitoneum, every 5 minutes during pneumoperitoneum, immediately after desufflation of CO2, at the end of surgery, after). ETCO2, peak inspiratory pressure (PIP) (after intubation, immediately after pneumoperitoneum, every 5 minutes during pneumoperitoneum, immediately after desufflation of CO2, at the end of surgery, after), operation time, PP time and intraoperative fluid administration were also recorded.
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Intervention code [1]
291883
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Early detection / Screening
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Intervention code [2]
291884
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Prevention
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Comparator / control treatment
PEEP 0 (zero) group is the control group.
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Control group
Dose comparison
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Outcomes
Primary outcome [1]
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Cerebral oxygen saturation values as assessed by near infrared spectroscopy
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Assessment method [1]
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Timepoint [1]
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Cerebral oxygen saturation values were continuously recorded from awake status to tracheal extubation
(basal, after induction, after intubation, immediately after pneumoperitoneum, every 5 minutes during pneumoperitoneum, immediately after desufflation of CO2, at the end of surgery, after).
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Secondary outcome [1]
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Hemodynamic parameters (HR, MBP) continuously recorded from the anaesthetic machine monitors.
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Assessment method [1]
314742
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Timepoint [1]
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Hemodynamic parameters (HR, MBP) were continuously recorded from awake status to tracheal extubation (basal, after induction, after intubation, immediately after pneumoperitoneum, every 5 minutes during pneumoperitoneum, immediately after desufflation of CO2, at the end of surgery, after).
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Secondary outcome [2]
314743
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Peak inspiratory pressure (PIP) values continuously recorded from the anaesthetic machine monitors.
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Assessment method [2]
314743
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Timepoint [2]
314743
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Peak inspiratory pressure (PIP) were recorded (after intubation, immediately after pneumoperitoneum, every 5 minutes during pneumoperitoneum, immediately after desufflation of CO2, at the end of surgery, after).
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Eligibility
Key inclusion criteria
Scheduled for elective laparoscopic cholecystectomy.
ASA physical status I and II.
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Minimum age
18
Years
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Maximum age
60
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Patients with morbid obessity (body mass index > 30 kg/m2), Patients with cerebrovascular disease,
Patients with respiratory disease,
Patients with cardiovascular disease,
Patients with metabolic disease
patients with acute cholecystitis.
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/07/2015
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Actual
1/07/2015
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Date of last participant enrolment
Anticipated
1/02/2016
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Actual
1/02/2016
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
105
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Accrual to date
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Final
105
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Recruitment outside Australia
Country [1]
6883
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Turkey
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State/province [1]
6883
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Konya
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Konya Training and Research Hospital
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Address [1]
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Konya Training and Research Hospital, Haci Saban Mah. Meram Yeniyol Caddesi No:97 Meram KONYA,
Postcode:42090
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Country [1]
291283
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Turkey
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Primary sponsor type
Hospital
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Name
Konya Training and Research Hospital
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Address
Konya Training and Research Hospital, Haci Saban Mah. Meram Yeniyol Caddesi No:97 Meram KONYA,
Postcode:42090
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Country
Turkey
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Secondary sponsor category [1]
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None
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Name [1]
289958
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Address [1]
289958
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Country [1]
289958
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
292849
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Necmettin Erbakan University Meram School of Medicine
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Ethics committee address [1]
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Necmettin Erbakan University Meram School of Medicine, Akyokus, Meram-Konya 42080
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Ethics committee country [1]
292849
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Turkey
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Date submitted for ethics approval [1]
292849
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04/07/2014
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Approval date [1]
292849
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09/07/2014
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Ethics approval number [1]
292849
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2014/97
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Summary
Brief summary
Laparoscopic surgeries have increased in frequency as replacements for a variety of surgical procedures. However, they require pneumoperitoneum, which raises concerns about the adverse effects on respiratory mechanics. It is demonstrated that application of positive end-expiratory pressure improved respiratory mechanics during pneumoperitoneum. Carbon dioxide (CO2) pneumoperitoneum also affects cerebral hemodynamics. We aimed to investigate changes in rSO2, as assessed by nearinfrared spectroscopy, associated with different PEEP levels during laparoscopic cholecystectomy.
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Trial website
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Trial related presentations / publications
Trial is in evaluation process.
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Public notes
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Contacts
Principal investigator
Name
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Dr Mehmet SARGIN
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Address
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Konya Training and Research Hospital, Anesthesiology and Reanimation Department, Haci Saban Mah. Meram Yeniyol Caddesi No:97 Post code: 42090 Meram KONYA
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Country
57318
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Turkey
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Phone
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+905322662766
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Fax
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Email
57318
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[email protected]
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Contact person for public queries
Name
57319
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Sadik OZMEN
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Address
57319
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Konya Training and Research Hospital, Anesthesiology and Reanimation Department, Haci Saban Mah. Meram Yeniyol Caddesi No:97 Post code: 42090 Meram KONYA
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Country
57319
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Turkey
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Phone
57319
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+903322212250
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Fax
57319
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Email
57319
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[email protected]
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Contact person for scientific queries
Name
57320
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Sadik OZMEN
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Address
57320
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Konya Training and Research Hospital, Anesthesiology and Reanimation Department, Haci Saban Mah. Meram Yeniyol Caddesi No:97 Post code: 42090 Meram KONYA
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Country
57320
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Turkey
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Phone
57320
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+903322212250
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Fax
57320
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Email
57320
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Comparison of the effects of different positive end-expiratory pressure levels on cerebral oxygen saturation with near infrared spectroscopy during laparoscopic cholecystectomy.
2017
https://dx.doi.org/10.1097/SLE.0000000000000372
N.B. These documents automatically identified may not have been verified by the study sponsor.
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