Effects of Pelviscopy on the PaCO2 and Hemodynamics / 대한마취과학회지

ABSTRACT

BACKGROUND: Pelviscopy has become popular because of the advantage of which less painful, less scarring, and shortening the hospitalizing stays, so to reduce the cost. This procedure require lithotomy- Trendelenburg position and pneumoperitoneum with carbon dioxide(CO2) gas insufflation, that affect arterial blood gas and hemodynamics. We studied the effects of pelviscopy on the PaCO2 and hemodynamics. METHODS: Twenty patients scheduled for pelviscopic hysterectomy were studied. All patients anesthetized with enflurane (2.0 vol%) - nitrous oxide (1.5 L/min) and oxygen (1.5 L/min), and controlled ventilation(tidal volume 10 ml/kg, respiratory rate 12 /min). Central venous pressure, blood pressure, heart rate and PaCO2 measured at postinduction(control), position change with CO2 gas insufflation, and every 15 minutes after pneumoperitoneum. RESULTS: Central venous pressure increased (P<0.05) through the procedure after position change and CO2 gas insufflation. Systolic blood pressure and heart rate decreased at 45min after pneumoperitoneum(P<0.05). Mean arterial pressure decreased at 75 min after pneumoperitoneum. PaCO2 increased at 15 min after position change and pneumoperitoneum(P<0.05). CONCLUSION: In our study, because central venous pressure and PaCO2 increased, we should attend to patients with hypertension, increased intracranial pressure, and increased PaCO2.