Neoplasms

Urinary Tract, Sexual Organs, and Pregnancy Conditions

All Conditions

Digestive System Diseases

Prostatic Neoplasms

Pneumoperitoneum

Genital Neoplasms, Male

Urogenital Neoplasms

Genital Diseases

Genital Diseases, Male

Urogenital Diseases

Prostatic Diseases

Male Urogenital Diseases

Pneumoperitoneum with Steep Trendelenburg position

Position

Young-Kug Kim, Professor

The purpose of this study is to evaluate the change of the internal carotid artery blood flow according to the steep trendelenburg position and pneumoperitoneum in patients undergoing robot-assisted laparoscopic prostatectomy.

Internal Carotid Artery Blood Flow in Robot-Assisted Laparoscopic Prostatectomy

Change of Internal Carotid Artery Blood Flow During Pneumoperitoneum With Steep Trendelenburg Position in Robot-Assisted Laparoscopic Prostatectomy

Difference between the internal carotid artery blood flow measured at 10 minutes after anesthetic induction during supine position and the internal carotid artery blood flow measured at 10 minutes after pneumoperitoneum with steep Trendelenburg position

Internal carotid artery blood flow before anesthetic induction

Internal carotid artery blood flow at 10 minutes after anesthetic induction

Internal carotid artery blood flow at 10 minutes after pneumoperitoneum and Trendelenburg position

Internal carotid artery blood flow at 30 minutes after pneumoperitoneum and Trendelenburg position

Internal carotid artery blood flow during supine position at skin closure

Asan Medical Center

Professor

Heart and Blood Diseases

Hypotension

Vascular Diseases

So Yeon Kim, MD, PhD

Evaluation the ability of each indicator of Cardio Q in predicting hypotension after position changes in robot-assisted laparoscopic radical prostatectomy

Hypotension is common in patients who undergo general anesthesia. Hypotension may cause hypoperfusion in the organs of the body, resulting in ischemia and increased mortality within one year. Hypotension may occur at any time during general anesthesia but may also occur with changes in posture. In robot-assisted laparoscopic radical prostatectomy, hypotension often occurs when posture is changed from a Trendelenburg position to a supine position. However there is no data regarding which hemodynamic parameters can predict hypotension induced by position change.

Excessive administration of the fluid in steep Trendelenburg position may lead to fluid overload and lead to complications such as pulmonary edema. Thus, the predictors are should be identified to manage patients without fluid overload. Therefore, the aim of this study is to investigate the parameters of Cardio Q which are useful for predicting hypotension after position change.

Ability of Cardio Q for Prediction of Hypotension

Ability of Cardio Q for Prediction of Hypotension After Postural Change in Robot-Assisted Laparoscopic Radical Prostatectomy

Severance Hospital

Associate professor

Gland and Hormone Related Diseases

Skin and Connective Tissue Diseases

Symptoms and General Pathology

Rare Diseases

Leiomyoma

Ovarian Neoplasms

Carcinoma, Ovarian Epithelial

Uterine Cervical Neoplasms

Myofibroma

Cholecystitis

Acalculous Cholecystitis

Cysts

Ovarian Cysts

Myoma

Ovarian Diseases

Adnexal Diseases

Genital Diseases, Female

Female Urogenital Diseases

Pregnancy Complications

Female Urogenital Diseases and Pregnancy Complications

Endocrine System Diseases

Gonadal Disorders

Gallbladder Diseases

Biliary Tract Diseases

Gastrointestinal Diseases

Neoplasms, Connective and Soft Tissue

Neoplasms by Histologic Type

Neoplasms, Connective Tissue

Connective Tissue Diseases

Ovarian Cancer

Ovarian Epithelial Cancer

Central Nervous System Depressants

All Drugs and Chemicals

Analgesics

Other Dietary Supplements

Anesthetics

Remifentanil

Desflurane

Benzocaine

Analgesics, Opioid

Narcotics

Anesthetics, Inhalation

Anesthetics, General

Tannic Acid

Drug: Desflurane Anesthesia with desflurane in both Group 1 and Group 2 - adjust minimum alveolar concentration (MAC) to maintain bispectral index (BIS) between 40-60

Drug: Remifentanil Adjuvant continuous administration

- adjust effect site concentration to maintain changes of vital sign below 20%

Device: Ultrasonographic measurement of ONSD

Procedure/Surgery: Mechanical ventilation Maintain the end-tidal carbon dioxide partial pressure between 35 and 40 mmHg and peak inspiratory pressure below 30 cmH2O.

Trendelenburg position - 30 degree

Drug: Desflurane Anesthesia with desflurane in both Group 1 and Group 2 - adjust MAC to maintain BIS between 40-60

Drug: Remifentanil Adjuvant continuous administration

- adjust effect site concentration to maintain changes of vital sign below 20%

Device: Ultrasonographic measurement of ONSD

Procedure/Surgery: Mechanical ventilation Maintain the end-tidal carbon dioxide partial pressure between 35 and 40 mmHg and peak inspiratory pressure below 30 cmH2O.

Reverse Trendelenburg position - 30 degree

Anesthesia with desflurane in both Group 1 and Group 2

- adjust MAC to maintain BIS between 40-60

Adjuvant continuous administration

- adjust effect site concentration to maintain changes of vital sign below 20%

Patients were placed in the supine position with their eyes closed, and a thick gel layer was applied to the closed upper eyelid. The 7.5-MHz linear probe was placed on the gel without excessive pressure and adjusted to the proper angle for displaying the entry of the optic nerve into the globe. The intensity of the ultrasound was adjusted to display optimal contrast between the retrobulbar echogenic fat tissue and the vertical hypoechoic band. An ultrasound beam was focused on the retrobulbar area (4 cm deep) using the lowest possible acoustic power that could measure ONSD. The ONSD was measured 3 mm behind the optic disc. Measurements were performed in the transverse and sagittal planes of both eyes, and the final ONSD value was calculated by averaging 4 measured values.

Ultrasonographic measurement of ONSD

After tracheal intubation, the lungs of the patients were then ventilated with oxygen in air (1:2) using a tidal volume of 8-10 mL/kg and a respiratory rate of 10-12/min, and the ventilation rate was adjusted to maintain the end-tidal carbon dioxide partial pressure between 35 and 40 mmHg and peak inspiratory pressure below 30 cmH2O.

Mechanical ventilation

Trendelenburg position - 30 degree

Reverse Trendelenburg position - 30 degree

Ki Tae Jung, M.D.

Increase of intracerebral pressure (ICP) during laparoscopic surgery has known to be associated with positional changes. Optic nerve sheath diameter (ONSD) has correlation with ICP and ultrasonographic measurement of optic nerve sheath diameter (ONSD) is known to be a noninvasive and rapidly applicable technique for evaluating ICP. The aim of this study is to investigate the change of ONSD according to the positional change during laparoscopic surgery.

1. Purpose There can be many physiologic changes during laparoscopic surgery. Increase of intracerebral pressure (ICP) is one of them, which has known to be associated with arterial concentration of carbon dioxide or positional changes. Changes of ICP can be measured directly by invasive method. However, optic nerve sheath diameter (ONSD) has correlation with ICP and ultrasonographic measurement of optic nerve sheath diameter (ONSD) is known to be a noninvasive and rapidly applicable technique for evaluating ICP. The aim of this study is to investigate the change of ONSD according to the positional change during laparoscopic surgery.
2. Hypothesis Changes of ONSD will be shown according to the positional change during laparoscopic surgery, and these can reflect the changes of ICP.
3. Objectives Female patients who are scheduled to undergo laparoscopic surgery, American society of anesthesiologist class (ASA) I-II, aged between 19 to 65 years, are allocated into 2 groups.

   * Group 1: Laparoscopic gynecological surgery, (Trendelenburg position)
   * Group 2: Laparoscopic cholecystectomy, (Reverse trendelenburg position)
4. Methods Patients are premedicated with midazolam 0.5 mg/kg before transported to the operating room. Once in the operating room, patients were monitored with electrocardiography, non invasive blood pressure, pulse oximetry (Datex-Ohmeda S/5, Planar Systems, Inc., Beaverton, OR, USA) and BIS (Aspect 2000, Aspect Medical Systems, Inc., Newton, MA, USA).

   Anesthesia are induced with propofol (2mg/kg) and followed by administering rocuronium 0.6 mg/kg. After tracheal intubation, the lungs of the patients were then ventilated with oxygen in air (1:2) using a tidal volume of 8-10 mL/kg and a respiratory rate of 10-12/min, and the ventilation rate was adjusted to maintain the end-tidal carbon dioxide partial pressure between 35 and 40 mmHg and peak inspiratory pressure below 30 cmH2O. Anesthesia is maintained with desflurane in addition to the continuous infusion of remifentanil. Radial arterial cannulation is done for invasive arterial blood pressure monitoring.

   After induction of anesthesia, when stabilization of cardiovascular status is achieved, optic nerve sheath diameter (ONSD) is measured by ultrasonographic measurement. Patients were placed in the supine position with their eyes closed, and a thick gel layer was applied to the closed upper eyelid. The 7.5-MHz linear probe was placed on the gel without excessive pressure and adjusted to the proper angle for displaying the entry of the optic nerve into the globe. The intensity of the ultrasound was adjusted to display optimal contrast between the retrobulbar echogenic fat tissue and the vertical hypoechoic band. An ultrasound beam was focused on the retrobulbar area (4 cm deep) using the lowest possible acoustic power that could measure ONSD. The ONSD was measured 3 mm behind the optic disc. Measurements were performed in the transverse and sagittal planes of both eyes, and the final ONSD value was calculated by averaging 4 measured values.

   ONSD was measured at 7 serial time points during surgery:
   1. Preinduction (prior to the induction of anesthesia in the operating room)
   2. 5 minutes after induction of anesthesia
   3. 5 minutes after introducing pneumoperitoneum
   4. 5 minutes after positional change
   5. 15 minutes after positional change
   6. 30 minutes after positional change
   7. 5 minutes after discontinuing pneumoperitoneum Arterial blood gas analysis is performed to evaluate the arterial carbon dioxide concentration (PaCO2) level at each time point.
5. Statistical Analysis All data are expressed as numbers (%) or mean ± standard deviation. Repeated measures ANOVA will be performed to compare the parameters at specific time points during surgery.

ONSD According to the Position During Laparoscopy

Comparison of Optic Nerve Sheath Diameter According to Position During Laparoscopy

ONSD - preinduction (prior to the induction of anesthesia in the operating room)

ONSD and PaCO2 - 5 minutes after induction of anesthesia

ONSD and PaCO2 - 15 min after positional change

ONSD and PaCO2 - 30 minutes after positional change

ONSD and PaCO2 - 5 minutes after discontinuing pneumoperitoneum

ONSD and PaCO2 - 5 minutes after introducing positional change

ONSD and PaCO2 - 5 minutes after introducing pneumoperitoneum

Chosun University Hospital

Assist professor

Adenoma

Neoplasms, Glandular and Epithelial

Herbal and Botanical

Cola

Patients change position (cecum to hepatic flexure, left lateral; transverse colon, supine; splenic flexure and descending colon , right lateral) during colonoscopy withdrawal.

Position change

In left lateral position group patients are positioned left lateral decubitus during colonoscopy withdrawal.

Left lateral

There was an only single operator study reporting dynamic position change during colonoscopy withdrawal significantly improved polyp and adenoma detection. So we designed a prospective, randomized multicenter study to verify the effect of dynamic position change in colonic adenoma detection. We think position change improve luminal distension and has the potential to improve adenoma detection rate.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Internal Carotid Artery Blood Flow in Robot-Assisted Laparoscopic Prostatectomy	NCT04615494	Prostate Cancer	Position	20 Years - 79 Years	Asan Medical Center
Ability of Cardio Q for Prediction of Hypotension	NCT03882697	Prostate Cancer		20 Years - 85 Years	Severance Hospital
ONSD According to the Position During Laparoscopy	NCT01937104	Cholecystitis Ovarian Cyst Ovarian Cancer Uterine Myoma Cervical Cancer	Desflurane Remifentanil Ultrasonographi... Mechanical vent... Trendelenburg p... Reverse Trendel...	19 Years - 65 Years	Chosun University Hospital
Dynamic Position Change in Colonic Adenoma Detection	NCT01366079	Position Colonoscopy Adenoma	Position change Left lateral	45 Years -	The Catholic University of Korea
ONSD According to the Position During Laparoscopy	NCT01937104	Cholecystitis Ovarian Cyst Ovarian Cancer Uterine Myoma Cervical Cancer	Desflurane Remifentanil Ultrasonographi... Mechanical vent... Trendelenburg p... Reverse Trendel...	19 Years - 65 Years	Chosun University Hospital

Spots Global Cancer Trial Database for position

Every month we try and update this database with for position cancer trials from around the world to help patients and their families find trials that might be right for them.
We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.

Spots Global Cancer Trial Database for position

Every month we try and update this database with for position cancer trials from around the world to help patients and their families find trials that might be right for them. We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.

Every month we try and update this database with for position cancer trials from around the world to help patients and their families find trials that might be right for them.
We offer this 100% free of charge and do not endorse any of the trials listed here, we hope it helps you or a loved one.