ABSTRACT
BACKGROUND: Retroperitoneoscopy for renal surgery is now a common procedure. We compared carbon dioxide absorption in patients undergoing retroperitoneoscopy for adrenal or renal surgery with that of patients undergoing laparoscopic cholecystectomy. METHODS: We measured carbon dioxide elimination with a metabolic monitor in 30 anaesthetized patients with controlled ventilation, undergoing retroperitoneoscopy (n=10), laparoscopy (n=10) or orthopaedic surgery (n=10). RESULTS: Carbon dioxide production increased by 38, 46 and 63% at 30, 60 and 90 min after insufflation (P<0.01) in patients having retroperitoneoscopy. Carbon dioxide production (mean (SD)) increased from 92 (21) to 150 (43) ml x min(-1) m(-2) 60-90 min after insufflation and remained increased after the end of insufflation. During laparoscopy, V(.)(CO(2)) increased less (by 15%) (P<0.05 compared with retroperitoneoscopy) and remained steady throughout the procedure. CONCLUSION: Retroperitoneal carbon dioxide insufflation causes more carbon dioxide absorption than intraperitoneal insufflation, and controlled ventilation should be increased if hypercapnia should be avoided.
Subject(s)
Carbon Dioxide/pharmacokinetics , Laparoscopy/methods , Absorption , Adrenal Glands/surgery , Adult , Aged , Anesthesia, General , Cholecystectomy, Laparoscopic , Humans , Insufflation/adverse effects , Kidney/surgery , Middle Aged , Oxygen Consumption , Pneumoperitoneum, Artificial , Retroperitoneal SpaceABSTRACT
Our experiment covered 123 patients who were given this new preparation with long action for various types of local and regional anesthesia. In 9 cases of peridural administration for several days, the total doses were very high and tolerance excellent. Results were good for all local and regional anesthesia for which this product was used: - Good local and general tolerance - Short latency period - Duration constantly and regularly prolonged: an average of 3 hours for non-adrenalin forms and 5 hours for adrenalin forms.
