Flow-Controlled Versus Volume-Controlled Ventilation in Lumbar Disc Herniation Surgery

Ankara Etlik City Hospital80 enrolled

Overview

This prospective randomized trial aims to compare the effects of flow-controlled ventilation (FCV) and volume-controlled ventilation (VCV) on intraoperative airway pressures and oxygenation in patients undergoing lumbar disc herniation surgery under general anesthesia. Adult patients aged 18-65 years, with ASA physical status I-III and a body mass index of 18-30 kg/m², will be allocated to receive either FCV or VCV during routine intraoperative mechanical ventilation. Ventilatory parameters, including peak airway pressure, plateau pressure, pulmonary compliance, EtCO₂, SpO₂, and arterial blood gas variables, will be recorded at predefined time points after intubation. The primary endpoint is the PaO₂ value measured after 20 minutes in the prone position. By comparing respiratory mechanics and oxygenation between the two ventilation modes, this study aims to contribute to the optimization of intraoperative ventilatory management in lumbar disc herniation surgery.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Conditions

Lumbar Disc Herniation Surgery Mechanical Ventilation

FCV GroupPROCEDURE

Patients allocated to the FCV group will receive intraoperative mechanical ventilation using a flow-controlled ventilation mode during surgery under general anesthesia. Patients will be started on ventilation after intubation with 50% oxygen, driving pressure 12, PEEP 5, and a 1:1 inspiration/expiratory ratio.

VCV GroupPROCEDURE

Patients allocated to the VCV group will receive intraoperative mechanical ventilation using a conventional volume-controlled ventilation mode throughout surgery under general anesthesia. Patients will be started on ventilation after intubation with 50% oxygen, 7 ml/ideal body weight tidal volume, PEEP 5, 12 breaths per minute frequency, and a 1:2 inspiration/expiration ratio.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age between 18 and 65 years * ASA physical status I-III * Body Mass Index between 18 and 30 kg/m² Exclusion Criteria: * Age \< 18 years or \> 65 years * Known or previously diagnosed pulmonary disease * Patients with severe preoperative pulmonary function impairment (e.g., FEV₁ \< 50% predicted, severe restrictive or obstructive pathology) * Patients with markedly altered lung anatomy or function due to prior major thoracic surgery * Patients who were dependent on supplemental oxygen therapy in the preoperative period * ASA physical status IV or higher * Refusal or inability to provide informed consent

Outcomes

Primary Outcomes

The PaO₂ measured 20 minutes after prone position.

The primary outcome measure will be the PaO₂ derived from arterial blood gas analysis at 20 minutes after the prone position.

Time frame: 20 minutes after the prone position, in the intraoperative period.

Secondary Outcomes

The PaO₂ measured during perioperative period

The PaO₂ values will be measured and recorded using arterial blood gas analysis.

Time frame: Day 1

Peak airway pressure (Ppeak) values during perioperative period

Ppeak will be measured and recorded.

Time frame: Day 1

Plateau airway pressure (Pplateau) values during perioperative period

Pplateau will be measured and recorded.

Time frame: Day 1

Flow-Controlled Versus Volume-Controlled Ventilation in Lumbar Disc Herniation Surgery

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes

Central Contacts