ABSTRACT
OBJECTIVE: To evaluate the influence of increased CO2 pneumoperitoneum pressure on the safety of laparoscopic operation and the patients' condition. DESIGN & METHODS: 326 patients were operated on with a constant 12 mmHg pressure of CO2 pneumoperitoneum (group A). 637 laparoscopies were performed (group B) with the pressure of 18 mmHg until the main trocar insertion. In both groups complications, early postoperative period and duration of analgesic therapy were assessed. In 30 patients from group A and 52 from group B, during the operation, we controlled: systolic, diastolic and mean arterial blood pressure, heart rate, saturation, peak and mean airway pressure, end-tidal CO2 (ETCO2) and minute lung capacity. The measurements were taken at the beginning of the operation, in the 1st, 2nd, 3rd and 5th min. for both groups, in 7th min. for group A and in 10th and 15th min. for group B. RESULTS: Neither surgical complications, nor harmful effects of pneumoperitoneum were observed. There were no differences in respiratory and circulatory functions, duration of hospitalization, time to mobilization, and amount of administered analgesics. CONCLUSIONS: Creation of pneumoperitoneum with the increased pressure of CO2 up to 18 mmHg until the insertion of the first trocar to the abdominal cavity is safe, well tolerated by the patients and more comfortable for the surgeon.
