A comparison of transcutaneous and end-tidal measurements of CO2 tension in laparoscopic surgery.
- Author:
Hey Ran CHOI
1
;
Yun Hee LIM
;
Hae Gyun PARK
;
Sangseok LEE
;
Jun Heum YON
;
Ki Hyuk HONG
Author Information
1. Department of Anesthesiology and Pain Medicine, Sanggye Paik Hostipal, College of Medicine, Inje University, Seoul, Korea. anelim1@sanggyepaik.ac.kr
- Publication Type:Case Report
- Keywords:
carbon dioxide;
laparoscopic surgery;
monitoring;
transcutaneous
- MeSH:
Bias (Epidemiology);
Carbon Dioxide;
Humans;
Laparoscopy;
Pneumoperitoneum
- From:Anesthesia and Pain Medicine
2009;4(1):55-59
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: In laparoscopic surgery with pneumoperitoneum, end-tidal CO2 (PeTCO2) monitoring may inaccurately estimate PaCO2 due to ventilation/perfusion mismatch. This study assessed the clinical usefulness and accuracy of transcutaneous CO2 (PtCCO2) monitoring during laparoscopic surgery. METHODS: Thirty-two patients with ASA physical status 1 requiring laparoscopic surgery were recruited. We measured PaCO2, PeTCO2, and PtCCO2 before and 20 min after pneumoperitoneum. To compare differences in PeTCO2/PaCO2 and PtCCO2/PaCO2, we determined bias values (mean difference between values) and precision (standard deviation of bias) with a Bland-Altman plot and compared them with a Student's t-test. RESULTS: Bias and precision values of PeTCO2/PaCO2 and PtCCO2/PaCO2 were 6.6 +/- 2.0 mmHg, 1.2 +/- 2.8 mmHg before pneumoperitoneum and 8.5 +/- 2.8 mmHg, 2.1 +/- 4.5 mmHg 20 min after pneumoperitoneum. PtCCO2/PaCO2 differences were significantly smaller than PeTCO2/PaCO2 differences (P< 0.05). CONCLUSIONS: In laparoscopic surgery, PtCCO2 monitoring is more accurate than PeTCO2 monitoring for assessing PaCO2 levels.
