Hemodynamic outcome of different ventilation modes in laparoscopic surgery with exaggerated trendelenburg: a randomised controlled trial.

PURPOSE: To compare hemodynamic effects of two different modes of ventilation (volume-controlled and pressure-controlled volume guaranteed) in patients undergoing laparoscopic gynecology surgeries with exaggerated Trendelenburg position. METHODS: Thirty patients undergoing laparoscopic gynecology operations were ventilated using either volume-controlled (Group VC) or pressure-controlled volume guaranteed mode (Group PCVG) (n = 15 for both groups). Hemodynamic variables were measured using Pressure Recording Analytical Method by radial artery cannulation in addition to peak and mean airway pressures and expired tidal volume. RESULTS: The only remarkable finding was a more stable cardiac index in Group PCVG, where other hemodynamic parameters were similar. Expired tidal volume increased in Group VC while peak airway pressure was lower in Group PCVG. CONCLUSION: PCV-VG causes less hemodynamic perturbations as measured by Pressure Recording Analytical Method (PRAM) and allows better intraoperative hemodynamic control in exaggerated Trendelenburg position in laparoscopic surgery.

An Eye-Popping Experience Immediately After Intubation: A Case Report.

This case presents and discusses a case of unilateral proptosis immediately following intubation in a patient who underwent laparoscopic ventral hernia repair under general anesthesia. The patient developed a right-sided proptosis following intubation when noninvasive blood pressure was measured as 167/111 mm Hg. The operation was postponed, and anesthesia was terminated. Proptosis resolved spontaneously following extubation. To the best of our knowledge, there is no case report of proptosis secondary to intubation. The aim of this report is to increase the awareness of rare complications caused by intubation, especially ocular complications, and to underline the importance of preoperative evaluation.