Effect of positive end-expiratory pressure on pulmonary compliance and pulmonary complications in patients undergoing robot-assisted laparoscopic radical prostatectomy: a randomized control trial

• Published in: BMC anesthesiology 2022-11, Vol.22 (1), p.347-347, Article 347
• Main Authors: Cheng, Menglan, Ni, Lifeng, Huang, Ling'er, Zhou, Yanfeng, Wang, Kuirong
• Format: Article
• Language: English
• Subjects: Analysis; Anesthesia; Atelectasis; Blood gas analysis; Blood gases; Carbon dioxide; Clinical trials; Extubation; General anesthesia; Hospital costs; Humans; Intubation; Laparoscopic surgery; Laparoscopy; Laparoscopy - adverse effects; Lungs; Male; Mechanical ventilation; Medical research; Medical societies; Medicine, Experimental; Muscle contraction; Oxygenation; Patient compliance; Patients; Pneumoperitoneum; Positive end-expiratory pressure; Positive-Pressure Respiration - adverse effects; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Postoperative Complications - prevention & control; Pressure; Prostate; Prostate cancer; Prostatectomy; Prostatectomy - adverse effects; Pulmonary Atelectasis - etiology; Pulmonary compliance; Recovery (Medical); Respiration; Robot-assisted laparoscopic radical prostatectomy; Robotic surgery; Robotic Surgical Procedures - adverse effects; Robotics; Robots; Statistical analysis; Surgery; Urological surgery
• ISSN: 1471-2253; 1471-2253
• DOI: 10.1186/s12871-022-01869-1

To observe the effects of different positive end-expiratory pressure (PEEP) ventilation strategies on pulmonary compliance and complications in patients undergoing robotic-assisted laparoscopic prostate surgery. A total of 120 patients with the American Society of Anesthesiologists Physical Status Class I or II who underwent elective robotic-assisted laparoscopic prostatectomy were enrolled. We randomized the patients divided into divided into three groups of 40 patients each: PEEP0, PEEP5, or PEEP10. Master Anesthetist used volume control ventilation intraoperatively with an intraoperative deep muscle relaxation strategy. Respiratory mechanics indexes were recorded at six time-points: 10 mimuts after anaesthesia induction, immediately after pneumoperitoneum establishment, 30 min, 60 min, 90 min, and at the end of pneumoperitoneum. Arterial blood gas analysis and oxygenation index calculation were performed 10 mimuts after anaesthesia induction, 60 mimuts after pneumoperitoneum, and after tracheal extubation. Postoperative pulmonary complications were also recorded. After pneumoperitoneum, peak inspiratory pressure (Ppeak), plateau pressure (Pplat), mean pressure (Pmean), driving pressure (ΔP), and airway resistance (Raw) increased significantly, and pulmonary compliance (Crs) decreased, persisting during pneumoperitoneum in all groups. Between immediately after pneumoperitoneum establishment, 30 min, 60 min, and 90 min, pulmonary compliance in the 10cmH OPEEP group was higher than in the 5cmH OPEEP (P