The effect of pneumoperitoneum and Trendelenburg position on respiratory mechanics during pelviscopic surgery

Autor: Min Kyo Suh, Kyu Wan Seong, Sung Hwan Jung, Seong Su Kim
Jazyk: angličtina
Rok vydání: 2010
Předmět:
Zdroj: Korean Journal of Anesthesiology, Vol 59, Iss 5, Pp 329-334 (2010)
Druh dokumentu: article
ISSN: 2005-6419
2005-7563
DOI: 10.4097/kjae.2010.59.5.329
Popis: BackgroundConventional pelviscopic surgery requires pneumoperitoneum with CO2 gas insufflation and lithotomy-Trendelenburg position. Pneumoperitoneum and Trendelenburg position may influence intraoperative respiratory mechanics in anesthetic management. This study was conducted to investigate the influence of pneumoperitoneum and Trendelenburg position on respiratory compliance and ventilation pressure.MethodsTwenty-five patients scheduled for elective gynecologic laparoscopy were evaluated. The patients had no preexisting lung or heart disease or pathologic lung function. Conventional general anesthesia with thiopental sodium, lidocaine, rocuronium, and sevoflurane was administered. The peak inspiratory pressure, plateau pressure, and end-tidal CO2 were measured before and after creation of pneumoperitoneum with an intraabdominal pressure of 12 mmHg, then after 10 minutes and 30 minutes in the 20° Trendelenburg position, and after deflation of pneumoperitoneum. The dynamic lung compliance was then calculated.ResultsFollowing creation of pneumoperitoneum, there was a significant increase in peak inspiratory pressure (6 cmH2O), plateau pressure (7 cmH2O), and end-tidal CO2 (5 mmHg), while dynamic lung compliance decreased by 12 ml/cmH2O. Overall, the Trendelenburg position induced no significant hemodynamic or pulmonary changes.ConclusionsThe effects of pneumoperitoneum significantly reduced dynamic lung compliance and increased peak inspiratory and plateau pressures. The Tredelenburg position did not change these parameters.
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