Know Cancer

forgot password

The Effect of Different I:E Ratio on Gas Exchange of Patients Undergoing Gynecologic Laparoscopic Surgery With Trendelenburg Position

20 Years
65 Years
Not Enrolling
Uterine Myoma, Ovarian Cyst, Laparoscopic Gynecologic Surgery

Thank you

Trial Information

The Effect of Different I:E Ratio on Gas Exchange of Patients Undergoing Gynecologic Laparoscopic Surgery With Trendelenburg Position

In patients undergoing gynecologic laparoscopic surgery with trendelenburg position, the
disturbance of pulmonary gas exchange frequently occurs due to high intra-abdominal
pressure. During the laparoscopic surgery with abdominal gas insufflation, gas exchange
disturbance such as CO2 retention, hypoxemia occurs in addition to high plateau airway
pressure. The usual strategy against these kinds of problem is pressure-controlled
ventilation. However, the gas exchange problem especially CO2 retention can not be solved in
some cases. The inverse-ratio ventilation (IRV), which prolongs the inspiratory time greater
than expiratory time, can be applied for adult respiratory distress syndrome. The efficacy
of IRV is to improve gas-exchange status by increasing mean airway pressure and alveolar
recruitment. There have been several clinical investigations which applied IRV during
general anesthesia. However, there have been debates about the effect of IRV during general
anesthesia. Therefore, we tried to apply the IRV for subjects undergoing laparoscopic
surgery, and evaluate the effect of different I:E ratio on the pulmonary gas exchange and
respiratory mechanics.

Inclusion Criteria:

- patients undergoing elective gynecologic laparoscopic surgery

- the duration of pneumoperitoneum during laparoscopic surgery is more than 40 minutes

Exclusion Criteria:

- ASA (American society of anesthesiologists) classification of the subjects more than

- Age under 20, or more than 65 years.

- Past history of pneumothorax, COPD, asthma.

- Patients with ischemic heart disease, valvular heart disease.

Type of Study:


Study Design:

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject)

Outcome Measure:

arterial CO2 partial pressure

Outcome Description:

arteial CO2 partial pressure

Outcome Time Frame:

10 minutes after induction of general anesthesia

Safety Issue:


Principal Investigator

Tae Soo Hahm, M.D.,Ph.D.

Investigator Role:

Study Director

Investigator Affiliation:

Samsung Medical Center


South Korea: Institutional Review Board

Study ID:




Start Date:

June 2011

Completion Date:

March 2012

Related Keywords:

  • Uterine Myoma
  • Ovarian Cyst
  • Laparoscopic Gynecologic Surgery
  • laparoscopic gynecologic surgery
  • gas exchange
  • inspiratory time
  • expiratory time
  • I:E ratio
  • Myoma
  • Ovarian Cysts
  • Leiomyoma
  • Myofibroma