The recent development of laparoscopic cholecystectomy introduced the technique of laparoscopy to the general surgical operation. During this procedure, the deliberate pneumoperitoneum with carbon dioxide(CO2) insufflation in order to visualize
better
the abdominal viscera may causes some problems-hypercarbia, hypertension, pneumomediastinum, subcutaneous emphysema and cardiovascular impairment. We studied the changes of cardiovascular system and pulmonary gas wxchanges clinically during
general
anesthesia for laparoscopic cholecystectomy in the 16 patients of Seoul National University Hospital. After induction of anesthsia, ventilation was controlled with tidal volume 10 ml/kg and respiration rate 10~15/min to maintain PaCO2 35 mmHg
before
insufflation of carbon dioxide. After measuring of control value of mean arterial pressure(MAP), heart rate(HR) and arterial blood gas analysis before insufflation of CO2 ventilation setting was not changed throughout the operation MAP, HR,
arterial
blood gas analysis were measured at 30min interval until the end of operation. The changes of MAP, HR and PaO2 throughout the operation are not statistically significant in comparison to control(preinsufflation) values. The PaCO2 was increased
significantly by 8~10 mmHg in comparison to control values(P-value<0.01). In conclusion, minute ventilation should be corrected during general anesthesia for laparoscopic cholecystectomy with CO2 insufflation according to continuous monitoring of
end
tidal CO2 and arterial carbon dioxide tension.
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