Effects of Low-Flow Anesthesia on Hemodynamic Parameters and Oxygenation in Morbidly Obese Patients

Inonu University

Status: Completed

Conditions: Hemodynamic Instability; Bariatric Surgery Candidate; Morbid Obesity

Treatments: Diagnostic Test: hemodynamic parameters; Diagnostic Test: arterial blood gase

Study type: Interventional

Funder types: Other

Identifiers

NCT03721536

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Details and patient eligibility

About

Low-flow anesthesia has been used for years with positive results, but its effects on hemodynamic parameters and oxygenation are not clearly known in high-risk morbidly obese patients who are prone to pulmonary dysfunction related to the obesity. Therefore, this prospective randomized study aimed to compare the effects of low-flow (0.75 L/min) and normal-flow (1.5 L/min) anesthesia on hemodynamic parameters and oxygenation in morbidly obese patients undergoing laparoscopic bariatric surgery.

Full description

Low-flow anesthesia has several potential benefits. It improves the flow dynamics of the inhaled air, increase mucociliary clearance, maintain body temperature, reduce fluid loss, result in savings of up to 75% and reduce greenhouse gas emissions and reduce treatment costs (10 - 13). However, it is necessary to examine whether the reduction of fresh gas flow affects the quality and safety of anesthesia management, especially during high-risk operations such as laparoscopic bariatric surgery.

Low-flow anesthesia has been used for years with positive results, but its effects on hemodynamic parameters and oxygenation are not clearly known in high-risk morbidly obese patients who are prone to pulmonary dysfunction related to the obesity. Therefore, this prospective randomized study aimed to compare the effects of low-flow (0.75 L/min) and normal-flow (1.5 L/min) anesthesia on hemodynamic parameters and oxygenation in morbidly obese patients undergoing laparoscopic bariatric surgery.

Enrollment: 48 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Morbidly obese patients with American Society of Anesthesiology (ASA) scores of III-IV,
• Aged 18-65 years old,
• BMI>40

Exclusion criteria

• Pregnant
• Uncontrolled diabetes mellitus,
• Cardiovascular disease,
• Pulmonary disease,
• Cerebrovascular disease,
• Drug and alcohol addiction.

Trial design

Primary purpose: Screening

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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48 participants in 2 patient groups

low-flow anesthesia

Active Comparator group

Description:

Patients in low-flow anesthesia receive a fresh gas flow of 4 L/min for the first 10 minutes and were then maintain with a fresh gas flow of 0.75 L/min. Patients will be monitored for hemodynamic parameters during the perioperative period. Arterial blood gase will be analyzed for the oxygenation.

Treatment:

Diagnostic Test: arterial blood gase

Diagnostic Test: hemodynamic parameters

normal-flow anesthesia

Active Comparator group

Description:

Patients in normal-flow anesthesia received a fresh gas flow of 4 L/min for the first 10 minutes and were then maintained with a fresh gas flow of 1.5 L/min. Patients will be monitored for hemodynamic parameters during the perioperative period. Arterial blood gase will be analyzed for the oxygenation.

Treatment:

Diagnostic Test: arterial blood gase

Diagnostic Test: hemodynamic parameters