The Effect of Combined General/Epidural Anesthesia Versus General Anesthesia on Diaphragmatic Function After Robot-assisted Prostatectomy
Diaphragmatic dysfunction after abdominal surgery can result in extended hospital stay and
increased medical costs, because it is related with atelectasis, lung collapse or pneumonia.
The mechanism of diaphragm dysfunction is thought to be from not only direct injury to
abdominal wall and viscera but inhibitory reflexes of phrenic activity. Thoracic or upper
abdominal surgery is suggested as a risk factor of postoperative diaphragm dysfunction, and
perioperative analgesic modality is also known to affect diaphragm movements. But there has
been no trial to investigate the effect of laparoscopic pelvic surgery such as prostatectomy
on diaphragm movement. Moreover, it is not clear if minimally invasive Robot-assisted
laparoscopic radical prostatectomy (RALRP) has any influence on respiratory and diaphragm
functions.
Interventional
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Change of diaphragm movement using sonography (diaphragm inspiratory amplitude, diaphragm inspiratory and expiratory velocity)on postoperative day 1 and 2 from baseline (day before surgery)
The measurements of diaphragmatic motion were attained at the posterior surface of the diaphragm. From the tracings on M-mode, the distance between echogenic lines (DIA) in cm and diaphragm inspiratory/expiratory velocity in cm.s-1 during quiet, deep, and sniff breathing were measured on the frozen images. Three consecutive sonographic examinations were performed, and the highest value of three measurements was recorded
on the day before surgery until postoperative day 2
No
Young Jun Oh, M.D. Ph.D.
Principal Investigator
Severance Hospital, Yonsi University Health System
South Korea: Korea Food and Drug Administration (KFDA)
4-2007-0344
NCT01547416
November 2011
May 2012
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