During shoulder arthroscopic surgery, extravasation of irrigation fluid can occur around the shoulder and trachea, compressing the upper airway. Although the extravasation is generally reabsorbed asymptomatically within 12 hours, there are cases that lead to reintubation or life-threatening complications. Furthermore, the soft tissue edema around the shoulder may extend to the thoracic cage, compress the chest and induce the respiratory distress immediately after surgery. The investigators attempt to determine the effect of shoulder arthroscopic surgery on respiratory mechanics. Changes in respiratory mechanics and arterial blood gases were measured and compared before and after the shoulder arthroscopic surgery.
Currently, most shoulder surgeries are performed with arthroscopy. The advantages of shoulder arthroscopic surgery are decreased blood loss due to minimal incision for scope, a reduced operation time, minimization of surgical stress, and rapid recovery time after surgery. During shoulder arthroscopic surgery, extravasation of irrigation fluid can occur around the shoulder and trachea, compressing the upper airway. Although the extravasation is generally reabsorbed asymptomatically within 12 hours, there are cases that lead to reintubation or life-threatening complications. Furthermore, the soft tissue edema around the shoulder may extend to the thoracic cage, compress the chest and induce the respiratory distress immediately after surgery. From these facts, the mechanism of respiratory discomfort after shoulder arthroscopic surgery may be because the upper airway obstruction or restrictive pathology due to direct compression of thoracic cage by the soft tissue edema. There have been no studies on the respiratory effect of shoulder arthroscopic surgery. We have observed frequent and severe respiratory discomfort after the shoulder arthroscopic surgery. Therefore, in this study we attempt to determine the effect of shoulder arthroscopic surgery on respiratory mechanics. Changes in respiratory mechanics and arterial blood gases were measured and compared before and after the shoulder arthroscopic surgery.
Study Type
OBSERVATIONAL
Enrollment
60
Samsung Medical Center
Seoul, South Korea
Static compliance
Static compliance (mL/cmH2O) before and after the arthroscopic surgery ,Static compliance = tidal volume delivered / (plateau pressure - PEEP)
Time frame: before and after arthroscopic surgery, an expected average of 80 minutes
dynamic compliance
dynamic compliance (mL/cm H2O) before and after the arthroscpic surgery ,dynamic compliance = tidal volume delivered / (peak pressure - PEEP)
Time frame: before and after arthroscopic surgery, an expected average of 80 minutes
inspiratory tidal volume
inspiratory tidal volume (ml) before and after the arthroscpic surgery
Time frame: before and after arthroscopic surgery, an expected average of 80 minutes
expiratory tidal volume
expiratory tidal volume (ml) before and after the arthroscpic surgery
Time frame: before and after arthroscopic surgery, an expected average of 80 minutes
peak inspiratory pressure
peak inspiratory pressure (cm H2O) before and after the arthroscpic surgery
Time frame: before and after arthroscopic surgery, an expected average of 80 minutes
physiologic dead space
physiologic dead space (VD/VT) before and after arthroscopic surgery ,VD/VT = (PaCO2 - PeCO2)/PaCO2, PeCO2 = mixed expired CO2
Time frame: before and after arthroscopic surgery, an expected average of 80 minutes
plateau airway pressure
plateau airway pressure (cmH2O) before and after arthroscopic surgery
Time frame: before and after arthroscopic surgery, an expected average of 80 minutes
Mean airway pressure
Mean airway pressure (cm H2O) before and after arthroscopic surgery
Time frame: before and after arthroscopic surgery, an expected average of 80 minutes
positive end expiratory pressure
positive end expiratory pressure (cmH2O) before and after arthroscopic surgery
Time frame: before and after arthroscopic surgery, an expected average of 80 minutes
inspiratory resistance
inspiratory resistance (cmH2O/L sec) before and after arthroscopic surgery
Time frame: before and after arthroscopic surgery, an expected average of 80 minutes
expiratory resistance
expiratory resistance (cmH2O/ L sec)before and after arthroscopic surgery
Time frame: before and after arthroscopic surgery, an expected average of 80 minutes
peak inspiratory flow
peak inspiratory flow (L/min) before and after arthroscopic surgery
Time frame: before and after arthroscopic surgery, an expected average of 80 minutes
peak expiratory flow
peak expiratory flow (L/min) before and after arthroscopic surgery
Time frame: before and after arthroscopic surgery, an expected average of 80 minutes
Work of breathing
Work of breathing (J/L) before and after arthroscopic surgery
Time frame: before and after arthroscopic surgery, an expected average of 80 minutes
end tidal CO2
end tidal CO2 (mmHg) before and after arthroscopic surgery
Time frame: before and after arthroscopic surgery, an expected average of 80 minutes
arterial oxygen tension
arterial oxygen tension (mmHg) measured by arterial blood gas analysis
Time frame: before and after arthroscopic surgery, an expected average of 80 minutes
arterial CO2 tension
arterial CO2 tension (mmHg)as measured by arterial blood gas analysis
Time frame: before and after arthroscopic surgery, an expected average of 80 minutes
forced vital capacity (FVC)
forced vital capacity measured by portable spirometry
Time frame: before and after general anesthesia, an expected average of 120 minutes
forced expiratory volume for 1 second (FEV1)
forced expiratory volume for 1 second (FEV1)measure by portable spirometry
Time frame: before and after general anesthesia, an expected average of 120 minutes
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