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KMID : 1155520090040010055
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Anesthesia and Pain Medicine
2009 Volume.4 No. 1 p.55 ~ p.59
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A comparison of transcutaneous and end-tidal measurements of CO2 tension in laparoscopic surgery
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Choi Hey-Ran
Lim Yun-Hee
Park Hae-Gyun
Lee Sang-Seok
Yon Jun-Heum
Hong Ki-Hyuk
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Abstract
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Background: In laparoscopic surgery with pneumoperitoneum, end-tidal CO2 (PeTCO2) monitoring may inaccurately estimate PaCO2 due to ventilation/perfusion mismatch. This study assessed the clinical usefulness and accuracy of transcutaneous CO2 (PtCCO2) monitoring during laparoscopic surgery.
Methods: Thirty-two patients with ASA physical status 1 requiring laparoscopic surgery were recruited. We measured PaCO2, PeTCO2, and PtCCO2 before and 20 min after pneumoperitoneum. To compare differences in PeTCO2/PaCO2 and PtCCO2/PaCO2, we determined bias values (mean difference between values) and precision (standard deviation of bias) with a Bland-Altman plot and compared them with a Student’s t-test.
Results: Bias and precision values of PeTCO2/PaCO2 and PtCCO2/PaCO2 were 6.6 +/- 2.0 mmHg, 1.2 +/- 2.8 mmHg before pneumoperitoneum and 8.5 +/- 2.8 mmHg, 2.1 +/- 4.5 mmHg 20 min after pneumoperitoneum. PtCCO2/PaCO2 differences were significantly smaller than PeTCO2/PaCO2 differences (P< 0.05).
Conslusion: In laparoscopic surgery, PtCCO2 monitoring is more accurate than PeTCO2 monitoring for assessing PaCO2 levels.
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KEYWORD
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carbon dioxide, laparoscopic surgery, monitoring, transcutaneous.
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