title: Comparison of volume controlled ventilation and pressure controlled ventilation in patients undergoing robot-assisted pelvic surgeries: An open-label trial.
abstract: OBJECTIVE
  Although volume controlled ventilation (VCV) has been the traditional mode of ventilation in robotic surgery, recently pressure controlled ventilation (PCV) has been used more frequently. However, evidence on whether PCV is superior to VCV is still lacking. We intended to compare the effects of VCV and PCV on respiratory mechanics and haemodynamic in patients undergoing robotic surgeries in steep Trendelenburg position.
  
  
  METHODS
  This prospective, randomized trial was conducted on sixty patients between 20 and 70 years belonging to the American Society of Anesthesiologist Physical Status I-II. Patients were randomly assigned to VCV group (n= 30), where VCV mode was maintained through anaesthesia, or the PCV group (n= 30), where ventilation mode was changed to PCV after the establishment of 40° Trendelenburg position and pneumoperitoneum. Respiratory (peak and mean airway pressure [APpeak, APmean], dynamic lung compliance [Cdyn] and arterial blood gas analysis) and haemodynamics variables (heart rate, mean blood pressure [MBP] central venous pressure) were measured at baseline (T1), post-Trendelenburg position at 60 min (T2), 120 min (T3) and after resuming supine position (T4).
  
  
  RESULTS
  Demographic profile, haemodynamic variables, oxygen saturation and minute ventilation (MV) were comparable between two groups. Despite similar values of APmean,APpeakwas significantly higher in VCV group at T2 and T3 as compared to PCV group (P< 0.001). Cdynand PaCO2were also better in PCV group than in VCV group (P< 0.001 and 0.045, respectively).
  
  
  CONCLUSIONS
  PCV should be preferred in robotic pelvic surgeries as it offers lower airway pressures, greater Cdynand a better-preserved ventilation-perfusion matching for the same levels of MV.
authors.affiliation: Department of Anaesthesiology and Critical Care, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India.
authors.forename: Rishabh
authors.initials: R
authors.lastname: Jaju
authors.affiliation: Department of Anaesthesiology and Critical Care, All Institute of Medical Sciences, Jodhpur, Rajasthan, India.
authors.forename: Pooja Bihani
authors.initials: PB
authors.lastname: Jaju
authors.affiliation: Department of Anaesthesiology and Critical Care, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India.
authors.forename: Mamta
authors.initials: M
authors.lastname: Dubey
authors.affiliation: Department of Anaesthesiology and Critical Care, All Institute of Medical Sciences, Jodhpur, Rajasthan, India.
authors.forename: Sadik
authors.initials: S
authors.lastname: Mohammad
authors.affiliation: Department of Anaesthesiology and Critical Care, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India.
authors.forename: A K
authors.initials: AK
authors.lastname: Bhargava
keywords: Pneumoperitoneum; Trendelenburg; pressure controlled ventilation; robotic pelvic surgeries; volume controlled ventilation