Does Trendelenburg Positioning During Pulmonary Recruitment Breaths Affect Post-laparoscopy Shoulder Pain

June 1, 2026 updated by: Ankita Gupta

Trendelenburg Positioning During Pulmonary Recruitment Breaths: A Randomized Controlled Trial

The goal of this clinical trial is to evaluate whether different positioning in the operating room during removal of laparoscopic surgical gas differs in post-surgery shoulder pain. An additional goal of this study is to evaluate whether positions change other post-surgery metrics such as bloating, time to passing gas, nausea and vomiting, and time to oral intake.

Researchers will compare Trendelenburg positioning where your head is tilted down to supine (level or flat) positioning during removal of surgical gas.

Participants will be asked to complete brief surveys at 24 and 72-hours post-surgery.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

120

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Robot-assisted laparoscopic surgery for benign gynecologic indication
  • Surgery is booked for 60 minutes or longer
  • Reliable working phone number or email

Exclusion Criteria:

  • Patients with baseline opioid use
  • Patients with existing shoulder or neck pain
  • Active malignancy-related pain or surgery for malignant indication
  • Concomitant upper abdominal or thoracic surgery
  • Pre-existing emphysema, chronic obstructive pulmonary disease, or pneumothorax
  • Non-English speaking

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Other
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: PRM Trendelenburg
PRM in Trendelenburg position (to 30 degrees or greatest degree patient can tolerate) with removal of tops of laparoscopic trocars
Procedure: Pulmonary recruitment maneuver
Active recruitment breaths delivered to patient by anesthesia provider as opposed to passive evacuation of pneumoperitoneum
Other Names:
  • Pulmonary recruitment breaths
  • Valsalva breath
Procedure: Trendelenburg position
Trendelenburg position as opposed to neutral (supine) position
Active Comparator: PRM Supine
PRM in neutral position with removal of tops of laparoscopic trocars
Procedure: Pulmonary recruitment maneuver
Active recruitment breaths delivered to patient by anesthesia provider as opposed to passive evacuation of pneumoperitoneum
Other Names:
  • Pulmonary recruitment breaths
  • Valsalva breath
No Intervention: Passive Supine
control group with passive evacuation of pneumoperitoneum: insufflation evacuation by removal of tops of laparoscopic trocars in neutral (supine) position

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Post-laparoscopy shoulder pain, 24 hour VAS
Time Frame: 24 hours post-operatively
Post-laparoscopy shoulder pain assessed on a visual analog scale zero to ten with zero representing no pain and ten representing the worst pain of their life.
24 hours post-operatively

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Post-laparoscopy shoulder pain, 72 hour VAS
Time Frame: 72-hours post-operatively
Post-laparoscopy shoulder pain assessed on a visual analog scale zero to ten with zero representing no pain and ten representing the worst pain of their life.
72-hours post-operatively
Pain Interference, 24 hour
Time Frame: 24 hours post-operatively
Pain interference assessed by PROMIS Pain Interference Short Form 8a questionnaire. A raw score ranges from 8 (least problems with pain hindering activities) to 40 (most problems with pain hindering activities).
24 hours post-operatively
Pain Interference, 72 hour
Time Frame: 72 hours post-operatively
Pain interference assessed by PROMIS Pain Interference Short Form 8a questionnaire. A raw score ranges from 8 (least problems with pain hindering activities) to 40 (most problems with pain hindering activities).
72 hours post-operatively
Total opioid use, 24 hr
Time Frame: 24-hours postoperatively
total opioid use measured by MME
24-hours postoperatively
Total opioid use, 72 hr
Time Frame: 72-hours postoperatively
total opioid use at 72-hr postoperatively measured by total MME
72-hours postoperatively
Time to flatus
Time Frame: up to 72-hours postoperatively
up to 72-hours postoperatively
Nausea and Vomiting, 24 hour
Time Frame: 24 hours post-operatively
Rhodes Index of Nausea Vomiting Retching is an 8-item questionnaire with scores ranging from 0 (no symptoms) to 32 (most severe symptoms).
24 hours post-operatively
Nausea and Vomiting, 72 hour
Time Frame: 72 hours post-operatively
Rhodes Index of Nausea Vomiting Retching is an 8-item questionnaire with scores ranging from 0 (no symptoms) to 32 (most severe symptoms).
72 hours post-operatively
Gas & Bloating, 24 hour
Time Frame: 24 hours post-operatively
Bloating measured by PROMIS Gas and Bloating 13a questionnaire. The raw summed score ranges from 3 (no symptoms) to 36 (worst reported symptoms).
24 hours post-operatively
Gas & Bloating, 72 hour
Time Frame: 72 hours post-operatively
Bloating measured by PROMIS Gas and Bloating 13a questionnaire. The raw summed score ranges from 3 (no symptoms) to 36 (worst reported symptoms).
72 hours post-operatively

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Ankita Gupta

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

June 1, 2026

Primary Completion (Estimated)

October 1, 2027

Study Completion (Estimated)

November 1, 2027

Study Registration Dates

First Submitted

May 1, 2026

First Submitted That Met QC Criteria

June 1, 2026

First Posted (Actual)

June 8, 2026

Study Record Updates

Last Update Posted (Actual)

June 8, 2026

Last Update Submitted That Met QC Criteria

June 1, 2026

Last Verified

June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 25.0897

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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