Changes of Vital Sign and Pulmonary Gas Exchange during General Anesthesia for Laparoscopic Cholecystectomy / 대한마취과학회지

ABSTRACT

Laparoscopic cholecystectomy is a relatively new surgical procedure, enjoying ever-increasing popularity and presenting new anesthetic challenges. Anesthetic problems are mostly due to physiologic changes associated with systemic absorption of the intra-peritoneally insufflated carbon dioxide (CO2). We studied systolic and diastolic arterial pressure, heart rate, arterial blood gas, end-tidal CO2 and peak inspiratory pressure changes in 30 patients who underwent laparoscopic cholecystectomy, before CO2 insufflation (control value), 15 minute after CO2 insufflation, after gall bladder delivery out, 15 minute after CO2 excretion. After CO2 insufflation, systolic and diastolic arterial pressure, peak inspiratory pressure, end-tidal CO2 were increased sigmficantly in comparison to control values (P-value<0.01). Also, in arterial gas analysis, arterial blood carbon dioxide tension (PaCO2) was increased and pH was decreased significantly but arterial blood oxygen tension (PaCO2) was not changed significantly. After CO2 excretion, systolic and diastolic pressure, end-tidal CO2 were increased in comparison to control values (P<0.01) and pH was decreased significantly. But peak inspiratory pressure and PaCO2 were not statistically significant. In conclusion, minute ventilation should be corrected during general anesthesia for laparoscopy with CO2 insufflation according to continuous monitoring of end-tidal CO2 and arterial carbon dioxide tension.