Comparison of pressure vs. volume controlled ventilation on oxygenation parameters of obese patients undergoing laparoscopic cholecystectomy

Backyround and Objective: There is no special guideline for the best ventilation mode during laparoscopic anesthesia in obese patients and there are too many studies with different controversial points

The aim of this study was to compare the effect of pressure controlled ventilation [PCV] vs. volume controlled ventilation [VCV] on respiratory and oxygenation parameters in patients undergoing laparoscopic cholecystectomy

Methods: Seventy patients with 30

Results: Patients in VCV group needed higher tidal volume and respiratory rate to maintain target C02 in 35 and 55 minutes after the study. Plateau pressure and mean airway pressure in two groups didn't have significant difference between two groups but peak airway pressure in 35 and 55 minutes after pneumoperitoneum was significantly higher in VCV group than PCV group. There were no significant differences between two groups regarding P02, PC02 and pH, except 35 and 55 minutes after pneumoperitoneum. In mentioned times, patients in PCV group had significantly higher P02 levels compared to VCV group

Conclusion: Despite some beneficial effects regarding plateau, mean airway pressure and oxygenation parameters with PCV, there was no significant clinical difference between PCV and VCV in obese patients undergoing laparoscopic cholecystectomy

Preincisional ipsilateral stellate ganglion block for acute post operative pain control in unilateral mastectomy

To evaluate the effect of preincisional ipsilateral stellate ganglion block for acute post operative pain control in unilateral mastectomy. In a randomized clinical trial, 62 patients selected for unilateral mastectomy were recruited in Tabriz Imam Reza educational Hospital during 18-month period. They were randomly divided into two equal groups; receiving either preincisional ipsilateral stellate ganglion block using bupivacaine [study group] or without these blocks [control group]. Postoperative pain was evaluated based on visual analogue scale [VAS]. The total dose of analgesics were also compared between the two groups. Thirty one female patients with a mean age of 48.7 +/- 7.4 [36-60] years and 31 other female patients with a mean age of 50.7 +/- 6.9 [36-60] years were enrolled in the study and control groups, respectively [p=0.292]. The number of patients with decrease in postoperative pain was significantly higher in the case study group comparing with that of the control group [p < 0.001]. Decrease in total dose of postoperative analgesics was also significantly lower in the case study group compared with control group [P < 0.001]. Forty eight hours after operation, there were 15 pain-free patients in the study group with no pain-free patients in the control group. This difference was statistically significant [P < 0.001]. Based on our findings, the preincisional ipsilateral stellate ganglion block is an effective method in controlling the postoperative pain after unilateral mastectomy. This approach had also got a considerable analgesic-sparing effect