Comparison of Low and Normal Flow Anesthesia in Robotic Assisted Radical Prostatectomy

The Effect of Low-flow and Normal-flow Desflurane Anesthesia on Respiratory Parameters in Robotic-assisted Radical Prostatectomy

Robot-assisted laparoscopic radical prostatectomy has gained increasing popularity compared to open radical prostatectomy with its advantages such as low blood loss, reduced blood transfusion rate, low complication rate, and shortened hospital stay. Since robot-assisted laparoscopic radical prostatectomy should be performed in the limited retroperitoneal area, insufflation of the abdomen with carbon dioxide (CO2) (pneumoperitoneum) and steep Trendelenburg position are required to provide better surgical vision.

Low-flow anesthesia warms and moistens the inhaled gases, creating a more physiological breathing atmosphere during anesthesia. In addition, it provides cost advantage by reducing inhalation agent consumption and reduces atmospheric pollution. Studies show that long-term minimal flow anesthesia is safe and advantageous for non-laparoscopic surgery.

The aim of this study is to compare low-flow (1L/min) with normal flow (3lt/min) desflurane anesthesia in terms of hemodynamic and respiratory parameters, inhalation agent consumption and soda lime consumption for robotic assisted laparoscopic radical prostatectomy surgery.

The secondary aim of the study is to compare the effects of low-flow and normal-flow anesthesia in the steep trendelenburg position (45°) used for robotically assisted laparoscopic radical prostatectomy.

Study Overview

• Status: Completed
• Conditions: Robotic Surgery; Low Flow Anesthesia; Normal Flow Anesthesia
• Intervention / Treatment: Procedure: robotic assisted radical prostatectomy

• Study Type: Observational
• Enrollment (Actual): 68

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Ankara
    • Ankara, Ankara, Turkey (Türkiye)
      • Ankara City Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 80 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

• Sampling Method: Probability Sample

Study Population

Patients who will undergo robotic-assisted laparoscopic prostatectomy surgery

Description

Inclusion Criteria:

- ASA I-II-III risk group

Exclusion Criteria:

• ASA IV, V,
• concomitant serious cardiac, respiratory, hepatic, renal disturbance,
• mental status disorder and hearing problem,
• anxiety and depression and/or other psychiatric disorders,
• patient's refusal

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
normal flow anesthesia; A fresh gas flow of 3 L/min will be applied continuously	Procedure: robotic assisted radical prostatectomy; Patients who will undergo robotic-assisted laparoscopic prostatectomy surgery
low flow anesthesia; A fresh gas flow of 3 L/min will be applied for the first 20 minutes after intubation , and then it will be reduced to 1 L/min.	Procedure: robotic assisted radical prostatectomy; Patients who will undergo robotic-assisted laparoscopic prostatectomy surgery

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
inspiratory O₂ concentration	inspiratory O₂ concentration is measured from anesthesia machine monitor	from beginning of anesthesia induction to the end of anesthesia (during periopertaive period)
partial oxygen pressure	PO2 from blood gas analysis	from beginning of anesthesia induction to the end of anesthesia (during periopertaive period)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
desflurane consumption	desflurane consumption at the end of anesthesia is measured from anesthesia machine monitor	perioperative
changes in liver and kidney function tests from the preoperative values to 48 hours postoperative	to determine the changes in serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood urea nitrogen (BUN), and creatinine from the preoperative values to 48 hours postoperative	during operation and 48 hours postoperative

Collaborators and Investigators

• Sponsor: Ankara City Hospital Bilkent

Study record dates

Study Major Dates

• Study Start (Actual): August 24, 2022
• Primary Completion (Actual): August 30, 2022
• Study Completion (Actual): November 30, 2023

Study Registration Dates

• First Submitted: August 23, 2022
• First Submitted That Met QC Criteria: August 24, 2022
• First Posted (Actual): August 26, 2022

Study Record Updates

• Last Update Posted (Actual): May 28, 2026
• Last Update Submitted That Met QC Criteria: May 23, 2026
• Last Verified: December 1, 2022

More Information

Terms related to this study

• Other Study ID Numbers: E1-22-2755

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No