ABSTRACT
Objective: The aim was to compare the effects of low tidal volume [V] and moderate positive end-expiratory pressure [PEEP] with high V and zero end-expiratory pressure [ZEEP] on postoperative pulmonary functions and oxygenation in patients undergoing robot-assisted laparoscopic radical prostatectomy
Subjects and Methods: Forty-four patients were randomized into low V-PEEP and high VT-ZEEP groups. The patients were ventilated with a V of 6 ml/kg and 8 cm H[2]O PEEP in the low VT-PEEP group and a V of 10 ml/kg and 0 cm H[2]O PEEP in the high V-ZEEP group. Preoperative and postoperative spirometric measurements were done and chest X-rays were evaluated using the radiological atelecta-sisscore[RAS].p< 0.05 wasconsidered statistically significant
Results:The intraoperative and postoperative arterial partial pressure of oxygen and arterial oxygen saturation values were significantly higher in the low V-PEEP group than in the high V-ZEEP group. At all times, the arterial-to-alveolar oxygenation gradients were significantly lower in the low VT-group than in the high V-ZEEP group. PreoperativeRAS were similar in both groups, but the postoperative RAS was significantly lower in the low VT-PEEP group [p < 0.001]. Forced vital capacity, forced expiratory volume in 1 s, and peak expiratory flow rate recorded postoperatively were significantly lower in the high VT-ZEEP group [p < 0.001]
Conclusions: Postoperative pulmonary functions were less impaired in patients ventilated with a V of 6 ml/kg and 8 cm H[2]O PEEP than in patients ventilated with a V of 10 ml/kg