The risk of bleeding is important during transsphenoidal surgery. This study aims to find if the ventilation mode, controlled pressure and controlled volume, modifies the risk of bleeding.
The risk of bleeding is important during transsphenoidal surgery. This study aims to find if the ventilation mode, controlled pressure and controlled volume, modifies the risk of bleeding. * group Volume controlled ventilation: tidal volume of 7 mL/kg ideal body weight, frequency of 12 cycles/minute, I/E ratio of 1:2, no positive end expiratory pressure. Ventilatory frequency is changed if necessary to maintain end-expiratory pressure of CO2 between 35 and 40 mmHg. * group Pressure-controlled ventilation: initial pressure of 15 cm H2O, frequency of 12 cycles/minute, I/E ratio of 1:2, no positive end expiratory pressure. Pressure is modified to maintain a tidal volume of 7 mL/kg of ideal body weight and frequency ventilation is modified to maintain end-expiratory pressure of CO2 between 35 and 40 mmHg. * In both groups, the fraction of inspired oxygen is 50%. A recruitment maneuver is performed if the blood oxygen saturation became less than 92%.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
101
Hopital Foch
Suresnes, France
intraoperative bleeding
intraoperative bleeding is estimated by the operator (always the same) as minimal (1), low (3), with no significant change in the conduct of the surgical procedure (5) with significant change in the conduct of surgical procedure (7). Intermediate levels are used to rate the levels of intermediate severity.
Time frame: 1 hour postoperatively
generated plateau pressures
mean ventilatory plateau pressure during surgery
Time frame: one hour after surgery
realisation of predefined objectives of minute ventilation
time spent with the predefined objectives of minute ventilation
Time frame: one hour after surgery
changes of ventilation mode
number of changes of ventilation mode
Time frame: one hour after surgery
arterial desaturation
number of episodes of arterial desaturation (SpO2 \<92%) and lower arterial saturation during surgery
Time frame: one hour after surgery
recruitment maneuver
number of recruitment maneuver
Time frame: one hour after surgery
duration of the surgical procedure
duration from surgical incision to end of the surgical procedure
Time frame: one hour after surgery
endocrine healing
return to a low level of the abnormal endocrin abnormalities
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Time frame: three months after surgery