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Trendelenburg Angle and Upper Airway Ultrasound Findings in Laparoscopic Hysterectomy (TAU-LH)

27. August 2026 aktualisiert von: Izmir City Hospital

Evaluation of the Effect of Trendelenburg Position on Upper Airway Edema by Ultrasonography and Its Relationship With Postoperative Clinical Airway Findings in Patients Undergoing Laparoscopic Hysterectomy

This observational study was designed to evaluate whether the Trendelenburg position used during laparoscopic hysterectomy is associated with swelling of the upper airway.

Women scheduled for elective laparoscopic hysterectomy under general anesthesia were included. During surgery, the angle of the operating table in the Trendelenburg position was measured. The upper airway was assessed with bedside ultrasound by measuring the distance from the skin to the epiglottis and the thickness of the tongue at different time points before and during surgery.

The study did not assign participants to any treatment or intervention. All participants received standard surgical and anesthetic care. After surgery, participants were monitored for early airway-related findings such as noisy breathing after extubation, need for extra oxygen, low oxygen saturation, or need for reintubation.

Studienübersicht

Status

Abgeschlossen

Bedingungen

Intervention / Behandlung

Detaillierte Beschreibung

Laparoscopic hysterectomy often requires carbon dioxide pneumoperitoneum and Trendelenburg positioning to improve surgical exposure. This position may shift fluid toward the head and neck region and may contribute to swelling of upper airway soft tissues.

This single-center prospective observational study included adult female participants scheduled for elective laparoscopic hysterectomy under general anesthesia. No study-related intervention was assigned. The Trendelenburg angle was determined by the surgical team according to routine clinical need and was recorded using a digital inclinometer.

Upper airway ultrasound measurements were performed at three perioperative time points: before anesthesia induction in the supine position, after Trendelenburg positioning, and at the end of surgery before return to the supine position. The measured ultrasound parameters were distance from skin to epiglottis and tongue thickness.

After extubation, participants were monitored in the post-anesthesia care unit and during the first 24 postoperative hours for clinical airway findings, including postextubation stridor, supplemental oxygen requirement, oxygen saturation below 94% on room air, and reintubation. The study aimed to assess the relationship between Trendelenburg angle, ultrasound-measured upper airway soft tissue changes, and early postoperative clinical airway findings.

Studientyp

Beobachtungs

Einschreibung (Tatsächlich)

68

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienorte

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

  • Erwachsene
  • Älterer Erwachsener

Akzeptiert gesunde Freiwillige

Nein

Probenahmeverfahren

Nicht-Wahrscheinlichkeitsprobe

Studienpopulation

Adult female patients scheduled for elective laparoscopic hysterectomy under general anesthesia at Izmir City Hospital, University of Health Sciences, Izmir, Turkey.

Beschreibung

Inclusion Criteria:

  • Female patients aged 18 to 65 years
  • Scheduled for elective laparoscopic hysterectomy
  • Planned surgery under general anesthesia
  • American Society of Anesthesiologists physical status I to III
  • Body mass index 35 kg/m² or lower
  • Provided written informed consent for study participation

Exclusion Criteria:

  • Known history of difficult airway or expected difficult airway on preoperative evaluation
  • Mallampati class III or IV
  • Congenital or acquired upper airway pathology
  • Neck mass or previous neck surgery
  • Body mass index greater than 35 kg/m²
  • Pregnancy
  • Emergency surgery
  • Known chronic respiratory disease, such as chronic obstructive pulmonary disease or advanced asthma
  • Upper respiratory tract infection within the previous three weeks
  • Inability to communicate in Turkish
  • Lack of cooperation
  • Conversion to open surgery
  • Requirement for blood transfusion or additional fluid resuscitation beyond the standard protocol
  • Significant hypotension requiring vasopressor support
  • Persistent high peak airway pressures with ventilatory difficulty
  • More than two intubation attempts
  • Withdrawal from the study

Exclusion Criteria:

-

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

Kohorten und Interventionen

Gruppe / Kohorte
Intervention / Behandlung
Laparoscopic Hysterectomy Cohort
Adult female participants scheduled for elective laparoscopic hysterectomy under general anesthesia. Participants received standard surgical and anesthetic care. No study-related intervention was assigned. Trendelenburg angle was determined according to routine surgical need and recorded during surgery. Upper airway ultrasound measurements were obtained perioperatively, and participants were monitored for postoperative clinical airway findings during the first 24 hours.
Sonstiges: Trendelenburg positioning during laparoscopic hysterectomy
Participants underwent elective laparoscopic hysterectomy under general anesthesia as part of standard clinical care. Trendelenburg positioning was applied according to routine surgical need and was not assigned by the study protocol. The Trendelenburg angle was measured and recorded during surgery. Upper airway ultrasound measurements were obtained before and during surgery, and participants were monitored for postoperative clinical airway findings during the first 24 hours.

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Change in distance from skin to epiglottis
Zeitfenster: From before anesthesia induction to the end of surgery before return to the supine position
Distance from skin to epiglottis was measured using point-of-care upper airway ultrasonography before anesthesia induction, after Trendelenburg positioning, and at the end of surgery before return to the supine position. The outcome was the change from baseline to the end of surgery, expressed in centimeters.
From before anesthesia induction to the end of surgery before return to the supine position

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Change in tongue thickness
Zeitfenster: From before anesthesia induction to the end of surgery before return to the supine position
Tongue thickness was measured using point-of-care upper airway ultrasonography before anesthesia induction, after Trendelenburg positioning, and at the end of surgery before return to the supine position. The outcome was the change in tongue thickness from baseline to the end of surgery, expressed in centimeters.
From before anesthesia induction to the end of surgery before return to the supine position

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

Izmir City Hospital

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Tatsächlich)

5. Februar 2026

Primärer Abschluss (Tatsächlich)

5. Mai 2026

Studienabschluss (Tatsächlich)

5. Mai 2026

Studienanmeldedaten

Zuerst eingereicht

27. August 2026

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

27. August 2026

Zuerst gepostet (Tatsächlich)

31. August 2026

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

31. August 2026

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

27. August 2026

Zuletzt verifiziert

1. August 2026

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Schlüsselwörter

Andere Studien-ID-Nummern

  • IZMIR-USG-TREND-2026-57
  • 2026/57 (Registrierungskennung: Izmir City Hospital Non-Interventional Clinical Research Ethics Committee)

Plan für individuelle Teilnehmerdaten (IPD)

Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?

JA

Beschreibung des IPD-Plans

De-identified individual participant data underlying the results reported in this study may be shared upon reasonable request. Shared data will not include any direct personal identifiers. Access will be subject to approval by the corresponding author and applicable institutional and ethics committee requirements.

IPD-Sharing-Zeitrahmen

Data may become available after publication of the main study results and may be available for 5 years after publication.

IPD-Sharing-Zugriffskriterien

Data may be made available to qualified researchers who submit a methodologically sound proposal for scientific purposes related to perioperative airway management, airway ultrasonography, or postoperative airway outcomes. Requests should be directed to the corresponding author. Data sharing will require appropriate institutional and ethics committee approval when applicable.

Art der unterstützenden IPD-Freigabeinformationen

  • STUDIENPROTOKOLL

Arzneimittel- und Geräteinformationen, Studienunterlagen

Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt

Nein

Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt

Nein

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