During laparoscopic surgery with carbon dioxide (CO2) pneumoperitoneum, PaCO2 (arterial CO2 gas tension) and PETCO2 (end-tidal CO2 gas tension) will be affected by the durations of CO2 pneumoperitoneum and the body positions.
PaCO2 and PETCO2 were investigated 5 minutes after induction of general anesthesia(control value), 10 minutes, 30 minutes and 60 minutes and 60 minutes after CO2 gas insufflation, and 15 minutes after CO2 gas excretion. Seventy-two patients
undergoing
laparoscopic surgery under general anesthesia were allocated to two study groups: group Ⅰ, laparoscopic appendectomy under the Trendelenburg position; group Ⅱ, laparoscopic cholecystectomy under the reverse Trendelenburg position.
In results, PaCO2 and PETCO2 were significantly increased during laparoscopic surgery that associated with times of CO2 pneumoperitoneum. PaCO2 and PETCO2 at 60 minutes after CO2 gas insufflation were increased from PaCO2 control value 35.8±4.2
mmHg,
PETCO2 control value 34.0±3.6 mmHg to PaCO2 39.9±8.0 mmHg, PETCO2 42.3±4.7 mmHg(p<0.05). PaCO2 in PETCO2 in groupⅠwere more increased compared with groupⅡ. PaCO2 and PETCO2 in groupⅠwere increased from PaCO2 control value 35.9±4.8 mmHg,
PETCO2
control value 34.9±3.7 mmHg to PaCO2 45.7±2.5 mmHg, PETCO2 48.0±3.6 mmHg(p<0.05), in groupⅡfrom PaCO2 control value 35.7±3.2 mmHg, PETCO2 control value 32.8±3.0 mmHg to PaCO2 38.4±8.3 mmHg, PETCO2 40.4±3.2 mmHg(p<0.05).
In conclusion, to minimize the risk of a carbon dioxide retension during laparoscopy especially under the Trendelenburg position, we recommend that ventilation should be adjusted to the normal range of PaCO2 and PETCO2. (Korean J Anesthesiol
1995;
29:
490∼494)
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