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KMID : 0371620020170020167
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Journal of Wonkwang Medical Science
2002 Volume.17 No. 2 p.167 ~ p.171
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Comparison of Different Positions during Pneumoperitoneum on Respiratory ettects
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Kim Kyeong-Il
Ha Jeong-Ryang
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Abstract
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Background: The purpose of this study is to investigate the influence of laparoscopic pneumoperitoneum with posture change on arterial blood gas and ventilation pressures.
Methods: We studied patients undergoing laparoscopic gynecologic surgery and cholecystectomy utilizing 20°of Trendelenburg lithotomy position, and reverse Trendelenburg lithotomy position, respectively. Measurements were taken after induction in supine position, creation of pneumoperitoneum with an intraabdominal insufflation pressure of 12 ㎜ Hg and position change. We checked peak inspiratory pressure (PIP), mean airway pressure (mPaw), expiratory tidal volume (V_T) and arterial blood gas. Lung compliance (C_eff rs) Was calculated as quotient of tidal volume and PEP.
Results: After insufflation of intraabdominal pressure of 12 ㎜ Hg, there was a significant increase of peak inspiratory pressure, mean airway pressure and PaCO_2, and there was a significant decrease of Lung compliance. Head up or down positions showed no significant respiratory changes compared to supine position.
Conclusions: Creation of intraabdominal pressure reduced respiratory system compliance, and increased peak inspiratory pressure, mean airway pressure, and arterial carbon dioxide during laparoscopic surgery. Head down or up positions did not further alter those parameters.
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KEYWORD
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Anesthesia, laparoscopy, pneumoperioneum, position
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