Trendelenburg Angle and Upper Airway Ultrasound Findings in Laparoscopic Hysterectomy (TAU-LH)
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.
調査の概要
詳細な説明
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.
研究の種類
入学 (実際)
連絡先と場所
研究場所
-
-
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Izmir、トルコ（Türkiye）
- İzmir City Hospital
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参加基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
サンプリング方法
調査対象母集団
説明
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:
-
研究計画
研究はどのように設計されていますか？
デザインの詳細
コホートと介入
グループ/コホート |
介入・治療 |
|---|---|
|
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.
|
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.
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Change in distance from skin to epiglottis
時間枠：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.
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From before anesthesia induction to the end of surgery before return to the supine position
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二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Change in tongue thickness
時間枠：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.
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From before anesthesia induction to the end of surgery before return to the supine position
|
協力者と研究者
スポンサー
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
その他の研究ID番号
- IZMIR-USG-TREND-2026-57
- 2026/57 (レジストリ識別子：Izmir City Hospital Non-Interventional Clinical Research Ethics Committee)
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
IPD プランの説明
IPD 共有時間枠
IPD 共有アクセス基準
IPD 共有サポート情報タイプ
- STUDY_PROTOCOL
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
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