Analysis of the effect of different pressure CO2 pneumoperitoneum on patients with laparoscopic gastrectomy / 中国医师杂志

ABSTRACT

Objective To compare the effect of different pressure CO2 pneumoperitoneum on hemodynamics and arterial blood gas in patients with laparoscopic gastrectomy.Methods 130 cases of patients with advanced or locally advanced distal gastric cancer in our hospital from June,2014 to December,2016 were selected and divided into three groups according to the random number table.The pressures of CO2 pneumoperitoneum were set at 6-8,9-11 and 12-14 mmHg in low pressure group,middle pressure group and high pressure group.The changes of heart rate (HR),mean arterial pressure (MAP),pH,partial pressure of oxygen (PaO2) and partial pressure of carbon dioxide (PaCO2) in three groups were measured before pneumoperitoneum (T1),60 minutes after pneumoperitoneum (T2),120 minutes after pneumoperitoneum (T3) and 60 minutes after discharge (T4).The complications of the three groups,such as abnormal intraoperative rhythm,hypercapnia,subcutaneous emphysema and air embolism were compared.Results Compared with T1,the HR and MAP of the three groups increased at T2,T3 and T4 points (P ＜0.05);The levels of HR,MAP and PaCO2 in T2,T3 and T4 points were higher in the middle pressure group and the high pressure group than that in the low pressure group at the same time point (P ＜ 0.05);There was no significant difference in pH value and PaO2 among the three groups (P ＞ 0.05);The incidence of central arrhythmia in the high pressure group was higher than that in the low pressure group and the middle pressure group (P ＜ 0.05).Conclusions The pressure of 6-8 mmHg CO2 pneumoperitoneum is conducive to maintain the hemodynamic stability of patients with laparoscopic gastrectomy and less impact on the PaCO2.