Evaluation effect of position change and pneumoperitoneum pressure on respiratory function in patients with DaVinci assisted radical prostatectomy / 中国实用护理杂志

ABSTRACT

Objective:To evaluate the effect of position change and pneumoperitoneum pressure on the respiratory system of patients undergoing DaVinci assisted laparoscopic prostate cancer surgery.Methods:Peak airway pressure, lung compliance and airway resistance were recorded by ventilator as the basic values to evaluate the change of respiratory function. When the artificial pneumoperitoneum pressure was 10 mmHg or 15 mmHg, the changes of respiratory function were recorded in five different positions: trendelenburg position (head low foot height) 30°, 15°, supine position, anti-trendelenburg position (head high foot height) 15° and 30°, peak airway pressure, lung compliance, airway resistance and so on.Results:At 10 mmHg and 30° trendelenburg, peak airway pressure, lung compliance and airway resistance were 28.13 cmH 2O, 23.33 ml/cmH 2O,16.06 cmH 2O·L -1·Sec -1, respectively. When the pneumoperitoneum pressure was adjusted to 15 mmHg, peak airway pressure increased to 32.03 cmH 2O, lung compliance decreased to 20.14 ml / cmH 2O, and airway resistance increased to 117.24 cmH 2O·L -1·Sec -1( P<0.01). At 10 mmHg and trendelenburg returned to 15°, peak airway pressure, lung compliance and airway resistance were 26.66 cmH 2O, 24.95 ml/cmH 2O,15.50 cmH 2O·L -1·Sec -1, peak airway pressure increased to 30.61 cmH 2O, the lung compliance decreased to 20.89 ml/cmH 2O and airway resistance increased to 16.66 cmH 2O·L -1·Sec -1 ( t value was -43.81, 24.638, -12.812, P<0.01). Conclusion:With the increase of trendelenburg position angle and artificial pneumoperitoneum pressure, the peak airway pressure and airway resistance are increased, while the lung compliance decreases gradually. Compared with trendelenburg position, the change of artificial pneumoperitoneum pressure has more influence on respiratory function.