Effects of Ultrasound-guided Recruitment Manoeuvres on Postoperative Pulmonary Complications in OSA Patients Undergoing Total Laparoscopic Hysterectomy

This study aims to evaluate the lung-protective effects of ultrasound-guided lung recruitment maneuvers in patients with OSA undergoing total laparoscopic hysterectomy and to explore the efficacy of EELV measurement in assessing the effectiveness of these maneuvers.

Study Overview

• Status: Recruiting
• Conditions: Total Laparoscopic Hysterectomy; Atelectasis, Postoperative
• Intervention / Treatment: Procedure: the sustained inflation recruitment maneuver; Procedure: the incremental PEEP recruitment maneuver; Procedure: the Ultrasound-guided recruitment maneuver

• Study Type: Interventional
• Enrollment (Estimated): 90
• Phase: Not Applicable

Contacts and Locations

Study Locations

• China
  • Henan
    • Xinxiang, Henan, China, 453100
      • Recruiting
      • The First Affiliated Hospital of Xinxiang Medical College
      • Contact: Kaiyuan Zheng; Phone Number: +86 13938459823; Email: zhengkaiyuan0624@163.cm

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Age ≥ 18 years;
• Scheduled for elective total laparoscopic hysterectomy;
• American Society of Anesthesiologists (ASA) I to III;
• BMI > 28 kg/m²;
• STOP-BANG score ≥ 3.

Exclusion Criteria:

• Abnormal findings on preoperative chest X-ray or CT, such as atelectasis, pneumothorax, thoracic deformity, pleural effusion, or neuromuscular diseases;
• Pre-existing severe pulmonary diseases;
• Severe cardiac arrhythmias or a history of cardiac surgery;
• Allergy to any medications used in the study.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: the SRM group; the sustained inflation recruitment maneuver group, n=30	Procedure: the sustained inflation recruitment maneuver; The APL valve on the anaesthesia machine will be adjusted to 30 cmH₂O, and the rapid oxygen inflow valve will be pressed to increase the pressure to the maximum, maintaining the pressure for 30 seconds.
Active Comparator: the PRM group; the incremental PEEP recruitment maneuver group, n=30	Procedure: the incremental PEEP recruitment maneuver; Starting from 5 cmH₂O, PEEP will be titrated upwards in 5 cmH₂O increments every 30 seconds until a maximum of 30 cmH₂O is reached. After maintaining for 40 seconds, PEEP will be decreased by 5 cmH₂O every 30 seconds until it returns to the pre-recruitment level.
Experimental: the URM group; the Ultrasound-guided recruitment maneuver group, n=30	Procedure: the Ultrasound-guided recruitment maneuver; Lung ultrasound will be performed on patients. If any lung region has an LUS score ≥ 2, ultrasound-guided RM will be performed; otherwise, no operation will be conducted. After the ultrasound examination, the probe will be positioned over the lung region exhibiting the most severe aeration loss (highest LUS) to guide the RMs. The ventilator will be set to pressure-controlled ventilation (PCV), maintaining the inspiratory pressure at 40 cmH₂O. PEEP will be gradually increased from 5 cmH₂O, with increments of 5 cmH₂O every 5-10 seconds, until ultrasound shows no atelectatic areas. The pressure will be maintained at 40 cmH₂O for 40 seconds. An airway pressure ceiling of 40 cmH₂O was established, and the pressure and the time used for the RM will be recorded.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
The lung ultrasound scores of patients after endotracheal intubation (T1), after the first lung recruitment procedure (T2), after the operation (T3), after the second lung recruitment procedure (T4), and 30 minutes after extubation (T5)	Perioperative

Secondary Outcome Measures

Outcome Measure	Time Frame
Recruitment volume measured by the ΔEELV method	Perioperative

Collaborators and Investigators

• Sponsor: The First Affiliated Hospital of Xinxiang Medical College

Study record dates

Study Major Dates

• Study Start (Actual): May 2, 2025
• Primary Completion (Estimated): August 31, 2026
• Study Completion (Estimated): August 31, 2026

Study Registration Dates

• First Submitted: December 18, 2025
• First Submitted That Met QC Criteria: January 15, 2026
• First Posted (Actual): January 23, 2026

Study Record Updates

• Last Update Posted (Actual): January 23, 2026
• Last Update Submitted That Met QC Criteria: January 15, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Respiratory Tract Diseases; Lung Diseases; Pulmonary Atelectasis
• Other Study ID Numbers: EC-25-117

Drug and device information, study documents

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