The Effect of Pneumoperitoneum and Trendelenburg position on respiratory mechanics under general anesthesia during gynecological laparoscopic surgery
- VernacularTitle:Эмэгтэйчүүдийн ерөнхий унтуулгатай дурангийн мэс заслын үеийн пнеумоперитонеум, Трендленбургийн байрлал амьсгалын үйл ажиллагаанд нөлөөлөхүй
- Author:
Uugangerel Ts
1
;
Bayartsogt N
1
;
Duurenbayar S
1
;
Sainzaya B
1
;
Ganbold L
2
Author Information
1. The Urguu Maternity Hospital, Ulaanbaatar, Mongolia
2. Mongolian National University of Medical Science, Ulaanbaatar, Mongolia
- Publication Type:Journal Article
- Keywords:
lung compliance;
pneumoperitoneum;
Tredelenburg position;
peak inspiratory pressure;
PIP;
intra-abdominal pressure;
IAP;
end-tidal carbon dioxide;
et CO2
- From:Mongolian Medical Sciences
2018;183(1):16-21
- CountryMongolia
- Language:Mongolian
-
Abstract:
Background:Gynecological laparoscopic surgery requires pneumoperitoneum(PP) with CO2 gas insufflation and Trendelenburg position. Pneumoperitoneum and Trendelenburg position may impact intraoperative respiratory mechanics in anesthetic management.The goal of this study was to evaluate the influence of Pneumoperitoneum and Trendelenburg position on respiratory mechanics and ventilation.
Methods:Twenty one patients scheduled for elective gynecological laparoscopy were evaluated. The patients had no preexisting lung and heart disease or pathologic lung function. Conventional general anesthesia with thiopental sodium, fentanyl, аtracrium and isoflurane was administered. The peak inspiratory pressure, plateau pressure, and end-tidal CO2 were compared before after creation of pneumoperitoneum with an intraabdominal pressure of 15 mmH2O, then after PP10, PP20, PP30 minutes in the 20° Trendelenburg position, and after deflation of pneumoperitoneum. The dynamic lung compliance was calculated.
Results:During of pneumoperitoneum, there were a significant increase in peak inspiratory pressure by 6 cmH2O, plateau pressure by 5 cmH2O, while dynamic lung compliance decreased by 11 ml/cmH2O.
General, the Trendelenburg position induced no significant hemodynamic and pulmonary changes.
Conclusion:The effects of pneumoperitoneum significantly reduced dynamic lung compliance and increased peak inspiratory and plateau pressures. The Tredelenburg position did not change these parameters. The end-tidal CO2 significantly increased after pneumoperitoneum and CO2 deflation.
- Full text:2018-183(1)-16-21.pdf
