Observation and analysis the impact of different laparoscopic surgical positions on respiratory,circulatory functions and postoperative symptoms of patients
10.3760/cma.j.issn.1674-2907.2012.28.003
- VernacularTitle:不同体位对腹腔镜手术患者呼吸循环功能及术后不适症状发生的影响
- Author:
Xue-Jun CUI
1
;
Xiu-Fen LI
;
Bei YAN
Author Information
1. 100730,卫生部北京医院手术室
- Keywords:
Laparoscopy;
Surgical position;
Respiratory and circulatory functions;
Influencing factor
- From:
Chinese Journal of Modern Nursing
2012;18(28):3356-3360
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of different laparoscopic surgical positions on respiratory and circulatory functions,and postoperative symptoms of patients.Methods Totals of 120 consecutive cases with different laparoscopic surgery positions were included and were divided into three groups with 40 cases each group:reverse trendelenburg position group,trendelenburg position group,and were lateral position group.Heart rate,blood pressure,oxygen saturation,end-tidal carbon dioxide partial pressure,and peak airway pressure (Ppeak) were collected at three time points:5 mins before the start of surgery pneumoperitoneum (T1),10 mins after pneumoperitoneum (T2) and 5 mins after the end of pneumoperitoneum (T3).Postoperative symptoms were recorded as following up.Results In three groups,respectively,the differences in systolic blood pressure,diastolic blood pressure and respiratory carbon dioxide partial pressure (PETCO2) were statistically significant (P ＜ 0.05).The blood pressure of T3 was significantly lower than that of T2 (P＜0.01).The level of SBP and DBP of were significantly higher than that of T3 and T1 (P＜0.01).No significant difference was detected in the heart rate change,and SpO2 of T2,T3 and T1 (P ＞ 0.05).In reverse trendelenburg position group,the level of Ppeak of T2 was significantly higher than that of T1,while lower than that of T3 (P ＜0.01).In trendelenburg position group,the levels of Ppeak of T2 and T3 were significantly higher than that of T1 (P ＜ 0.01).No significant difference was found in the levels of Ppeak of lateral position group (P ＞ 0.05).And no significant difference was found in the incidence of abdominal discomfort symptoms between three groups (P ＞ 0.05).The incidence of discomfortable symptoms of reverse trendelenburg position group,trendelenburg position group and ateral position group,respectively was 15.0％,42.5％,15.0％,and the incidence of shoulder paìn after surgery of trendelenburg position group was significantly higher than that of other groups (P ＜ 0.01).Conclusions Pneumoperitoneum pressure and different positions can affect both the respiratory and circulation function of patients that undergoing laparoscopic surgery.And positions may affect the incidence of postoperative shoulder pain.
