Laparoscopic surgery is a new technique gaining increasing popularity because of the small, limited incision and the benefit of better and faster recovery compared with that after open laparotomy. These laparoscopic procedures use carbon dioxide
to
establish artificial pneumoperitoneum. Insufflation of carbon dioxide (CO2) into the peritoneal surface.
We studied the arterial blood gas changes of laparoscopic surgery versus open laparotomy which is a kind of surgery of the same scale as appendectomy in twenty patients each. For the statistical analysis of the variables in the study, the t-test
and
ANOVA were used to assess the significance of differences between two groups, with p values less than 0.05 as statistically significant.
Initially, the operation times of laparocopy and laparotomy were statistically insignificant. The highest and the lowest blood pressure and heart beats during the operation, of the two groups were not statistically different.
Similarly, the electrolyte parameters, sodium and potassium obatained preoperatively, 30 minutes after starting the operation, and one hour after completing the operation revealed no significant differences between two groups However, the
patients
with
laparoscopic surgery had increased PaO2 (p<0.01) and PaCO2 (p<0.05) value during the operation compared with preoperative values. The pH valuc in laparotomy increased during the operation (p<0.01) compared with the value of laparoscoic surgery.
Bicarbonate deficit and O2 saturation in arterial blood were slightly increased during operation compared with preoperative period, but there were not statistically different. In summary, pneumoperitoneum induced by CO2 insufflation for
laparoscopic
surgery had not any harmful hemodynamic or respiratory effect in the healthy person. We need to further study the harinful effects of CO2 pneumoperitoneum, especially in the pateitns with poor carciopulmonary function.
|