The Effect of Pneumoperitoneum and Trendelenburg position on respiratory mechanics under general anesthesia during gynecological laparoscopic surgery / Монголын Анагаах Ухаан
Mongolian Medical Sciences
;
: 16-21, 2018.
Article
in English
| WPRIM
| ID: wpr-973014
ABSTRACT
Background@#Gynecological laparoscopic surgery requires pneumoperitoneum(PP) with CO<sub>2</sub> gas insufflation and Trendelenburg position. Pneumoperitoneum and Trendelenburg position may impact intraoperative respiratory mechanics in anesthetic management.The goal of this study was to evaluate the influence of Pneumoperitoneum and Trendelenburg position on respiratory mechanics and ventilation. @*Methods@#Twenty one patients scheduled for elective gynecological laparoscopy were evaluated. The patients had no preexisting lung and heart disease or pathologic lung function. Conventional general anesthesia with thiopental sodium, fentanyl, аtracrium and isoflurane was administered. The peak inspiratory pressure, plateau pressure, and end-tidal CO<sub>2</sub> were compared before after creation of pneumoperitoneum with an intraabdominal pressure of 15 mmH<sub>2</sub>O, then after PP10, PP20, PP30 minutes in the 20° Trendelenburg position, and after deflation of pneumoperitoneum. The dynamic lung compliance was calculated.@*Results@#During of pneumoperitoneum, there were a significant increase in peak inspiratory pressure by 6 cmH<sub>2</sub>O, plateau pressure by 5 cmH<sub>2</sub>O, while dynamic lung compliance decreased by 11 ml/cmH<sub>2</sub>O. General, the Trendelenburg position induced no significant hemodynamic and pulmonary changes.@*Conclusion@#The effects of pneumoperitoneum significantly reduced dynamic lung compliance and increased peak inspiratory and plateau pressures. The Tredelenburg position did not change these parameters. The end-tidal CO<sub>2</sub> significantly increased after pneumoperitoneum and CO<sub>2</sub> deflation.
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Index:
WPRIM (Western Pacific)
Language:
English
Journal:
Mongolian Medical Sciences
Year:
2018
Type:
Article
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