Minimal Flow Application in One Lung Ventilation

The Effects of Minimal Flow Anesthesia on Hemodynamic Parameters, Compilation and Gas Consumption in Single Lung Ventilation

Interest in low fresh gas flow anesthesia has increased in recent years. The high standard of anesthesia machines, the presence of monitors that continuously and thoroughly analyze the anesthetic gas composition, and the increased knowledge of the pharmacodynamics and pharmacokinetics of inhalation anesthetics greatly facilitated the safe administration of low-flow anesthesia.Low-flow anesthesia can be mentioned for most patients if modern re-breathing systems are used but only if the fresh gas flow rate is reduced below 2 lt / min. In 1974, Virtue was defined as a technique called minimal flow, in which the fresh gas flow was not exceeded 0.5 lt / min. Although there are too many applications for low current in the literature, there is little literature for use in one lung.

Study Overview

• Status: Unknown
• Conditions: Ventilator Lung; Anesthesia; Functional
• Intervention / Treatment: Procedure: minimal flow anesthesia

Detailed Description

Our research is planned prospectively. During the preoperative examination, patients will be informed about the study and their written consent will be obtained. On the morning of the operation, anesthesia gas monitor calibration and leak test will be started with automatic tests of the anesthesia device (Drager-Perseus A500).The leak test for the ventilator and breathing circuit for the patient will be repeated in all operations. The carbon dioxide trap will be evaluated in terms of its dryness and color and will be replaced at appropriate times. The patients who were taken to the operation table were venously opened with a 20-gauge cannula from the back of the hand, and perfusion of 10 ml / kg / h 0.9% sodium chloride was started. ECG, SPO2, NIBP monitoring (Siemens SC-7700), starting before anesthesia (basal), after induction, after intubation 1.min and 5., 10., 15., 20., 25., 30., 40 ., 50th, 60th, 75th, 90th, 105th, 120th minutes and preoperative arterial blood gas (AKG) will be taken.1μg / kg fentanyl (Fentanyl Citrate, Abbott Lab. North Chicago, USA), 5-7 mg / kg thiopental (Pental) for anesthesia induction after preoxygenation in 100% O2 and fresh gas flow 4L / min with spontaneous breathing for 3 minutes with mask sodium, IE Ulagay, Istanbul, Turkey) and 0.1 mg / kg vecuronium (Norcuro, Organon, Oss. the Netherlands) was administered iv. When muscle relaxation was observed, orotracheal intubation was performed and the patient (Dräger Perseus) was adjusted with an anesthesia device to have a tidal volume of 7-10 ml / kg, respiratory frequency 12 / min, and the ratio of I: E 1: 2. The tube was placed by selective intubation with the help of fiberoptic bronchoscopy. MAC values will be kept between 4-6%. Alarm limits FiO2 30% lower limit, desflurane 10% vol upper limit, EtCO2 45mmhg upper limit Paw 5cmh20 six lower limit, 30cmh2o upper limit set. co2 absorbent, as sodalime (Sorbo-lime, Berk, Turkey) were used.

Arterial Blood Gas (ABG) analysis will be performed at zero and then half hour intervals of single lung ventilation. Special attention will be paid not to open the system. Muscle relaxant antagonism will be achieved in all patients with 0.01mg / kg of atropine and 0.03mg / kg of neostigmine. At the end of the operation, the recovery period characteristics of all patients at the 1st, 5th, and 10th minutes before and after extubation were evaluated with Aldrete Kraulik's post-anesthesia evaluation system. Gas consumption amounts will be monitored on the monitor and recorded.

• Study Type: Interventional
• Enrollment (Anticipated): 60
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey
  • Istanbul, Turkey, 34860
    • Recruiting
    • University of Health Sciences Kartal Dr. Lutfi Kirdar Education and Research Hospital
    • Contact: Fatih Dogu Geyik, MD; Phone Number: +905055671264; Email: dogugeyik@hotmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 85 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• ASA 1-3 Patients
• Single lung ventilation during the operation
• Age>18

Exclusion Criteria:

Age<18

• ASA 4
• pregnancy
• COPD patients

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Diagnostic
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: minimal flow anesthesia; the patiennts who have thoracic sugery with one lung ventilaiton	Procedure: minimal flow anesthesia; Investigators will use minimal flow anesthesia (0,5 lt/min) during surgery with one lung ventilation

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Operation time	minutes	during surgery
Age	Years	during surgery
Gender	Male/Female	during surgery
ASA :	I, II, III, IV	during surgery
Height:	centimeter	during surgery
Weight	kilogram	during surgery
BMI:	kg/m2	during surgery
Side of surgery	left /right	during surgery
Side of double lumen tube	left/right	during surgery
Desfluran consumption	ml	during surgery
Heart Rate	beats /minute	during surgery
SpO2	percent	during surgery
Systolic Blood Pressure	mmHg/min	during surgery
Diastolic Blood Pressure	mmHg/min	during surgery
Respiratory Rate	frequency/ min	during surgery
Intubation tube size	french	during surgery
duration of anesthesia	minutes	during surgery
Duration of single lung ventilation	minutes	during surgery

Collaborators and Investigators

• Sponsor: Dr. Lutfi Kirdar Kartal Training and Research Hospital

Publications and helpful links

General Publications

• Baum JA. Low-flow anesthesia: theory, practice, technical preconditions, advantages, and foreign gas accumulation. J Anesth. 1999;13(3):166-74. doi: 10.1007/s005400050050. No abstract available.
• Honemann CW, Hahnenkamp K, Mollhoff T, Baum JA. Minimal-flow anaesthesia with controlled ventilation: comparison between laryngeal mask airway and endotracheal tube. Eur J Anaesthesiol. 2001 Jul;18(7):458-66. doi: 10.1046/j.1365-2346.2001.00868.x.

Study record dates

Study Major Dates

• Study Start (Actual): May 5, 2020
• Primary Completion (Anticipated): August 31, 2020
• Study Completion (Anticipated): September 1, 2020

Study Registration Dates

• First Submitted: April 24, 2020
• First Submitted That Met QC Criteria: May 4, 2020
• First Posted (Actual): May 6, 2020

Study Record Updates

• Last Update Posted (Actual): May 6, 2020
• Last Update Submitted That Met QC Criteria: May 4, 2020
• Last Verified: May 1, 2020

More Information

Terms related to this study

• Keywords: one lung ventilation; low flow anesthesia; gas consumption
• Additional Relevant MeSH Terms: Physiological Effects of Drugs; Central Nervous System Depressants; Anesthetics
• Other Study ID Numbers: 2020/514/172/15

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No