The goal of this clinical trial is to determine whether different ventilatory strategies improve oxygenation and hemodynamic stability in patients undergoing robot-assisted radical prostatectomy under general anesthesia. The study will also evaluate the safety and physiological effects of applying positive end-expiratory pressure (PEEP) and alveolar recruitment maneuver (ARM) during surgery. The main questions this study aims to answer are: Does the application of PEEP or PEEP combined with ARM improve intraoperative oxygenation compared with conventional mechanical ventilation? How do PEEP and ARM affect intraoperative hemodynamic parameters such as cardiac output and stroke volume during pneumoperitoneum and steep Trendelenburg positioning? Are there any adverse events associated with the use of these ventilatory strategies during surgery? Researchers will compare three ventilation strategies-conventional ventilation without PEEP, ventilation with PEEP alone, and ventilation with PEEP combined with ARM-to evaluate their effects on perioperative oxygenation and cardiovascular function. Participants will: Undergo robot-assisted radical prostatectomy under general anesthesia Be randomly assigned to receive one of three ventilatory strategies during surgery Receive standardized anesthetic management and intraoperative monitoring Have arterial blood gas analysis and hemodynamic measurements performed at predefined time points during surgery and recovery
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Intraoperative oxygenation assessed by the arterial partial pressure of oxygen to inspired oxygen fraction ratio
Timeframe: T0 (15 min after induction), T1 (10 min after pneumoperitoneum and Trendelenburg), T2 (30 min after T1), T3 (30 min after T2), T4 (30 min after T3), T5 (before the end of surgery), and T6 (30 min after arrival in the post-anesthesia care unit)