Effects of pneumoperitoneal pressure and position changes on respiratory mechanics during laparoscopic colectomy.
10.4097/kjae.2012.63.5.419
- Author:
Jin Suk PARK
1
;
Eun Jin AHN
;
Duk Dong KO
;
Hyun KANG
;
Hwa Yong SHIN
;
Chong Hwa BAEK
;
Yong Hun JUNG
;
Young Cheol WOO
;
Jin Yun KIM
;
Gill Hoi KOO
Author Information
1. Department of Anesthesiology and Pain Medicine, College of Medicine, Chung-Ang University, Seoul, Korea. roman00@naver.com
- Publication Type:Original Article
- Keywords:
Laparocolectomy;
Pneumoperitoneum;
Position;
Respiratory mechanics
- MeSH:
Airway Resistance;
Colectomy;
Compliance;
Humans;
Laparoscopy;
Lung Compliance;
Pneumoperitoneum;
Respiratory Mechanics
- From:Korean Journal of Anesthesiology
2012;63(5):419-424
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: This study was designed to assess the effects of pneumoperitoneal pressure (PP) and positional changes on the respiratory mechanics during laparoscopy assisted colectomy. METHODS: Peak inspiratory pressure, plateau pressure, lung compliance, and airway resistance were recorded in PP of 10 mmHg and 15 mmHg, with the position change in 5 steps: head-down at 20degrees, head-down at 10degrees, neutral position, head-up at 10degrees and head-up at 20degrees. RESULTS: When the patient was placed head-down, the position change accentuated the effects of pneumoperitoneum on respiratory mechanics. However, when the patient was placed in a head-up position during pneumoperitoneum the results showed no pattern. In the 20degrees head-up position with the PP being 10 mmHg, the compliance increased from 30.6 to 32.6 ml/cmH2O compared with neutral position (P = 0.002). However with the PP being 15 mmHg, the compliance had not changed compared with neutral position (P = 0.989). In 20degrees head-down position with the PP of 10 mmHg, the compliance was measured as 24.2 ml/cmH2O. This was higher than that for patients in the 10degrees head-down position with a PP of 15 mmHg, which was recorded as 21.2 ml/cmH2O. Also in the airway resistance, the patient in the 20degrees head-down position with the PP of 10 mmHg showed 15.8 cmH2O/L/sec, while the patient in the 10degrees head-down position with the PP of 15 mmHg showed 16.2 cmH2O/L/sec of airway resistance. These results were not statistically significant but still suggested that the head-down position accentuated the effects of pneumoperitoneum on respiratory mechanics. CONCLUSIONS: Our results suggest that respiratory mechanics are affected by the patient position and the level of PP - the latter having greater effect.
