Changes in Respiratory Mechanics during Laparoscopic Surgery with a Special Reference to the Effects of Pneumoperitoneum and Abdominal Wall Elevation on Respiratory Compliance

Accession number;05A0625474
Title;Changes in Respiratory Mechanics during Laparoscopic Surgery with a Special Reference to the Effects of Pneumoperitoneum and Abdominal Wall Elevation on Respiratory Compliance
Author; KAWAHARA RYOKO (Nissei Hospital, JPN) AMANO EIZO (Nissei Hospital, JPN) FUJISAKI EMIKO (Nissei Hospital, JPN) MORIOKA YUKINORI (Nissei Hospital, JPN)
Journal Title;Japanese Journal of Intensive Care Medicine
Journal Code:Z0581B
ISSN:0389-1194
VOL.29;NO.5;PAGE.389-393(2005)
Figure&Table&Reference;FIG.4, TBL.2, REF.9
Pub. Country;Japan
Language;Japanese
Abstract;We studied the influence of pneumoperitoneum and abdominal wall lifting with postural changes upon respiratory mechanics during laparoscopic surgery. Thirty-seven patients undergoing laparoscopic surgery were divided into 3 groups; 15 patients undergoing hysterectomy in a head down position (Group H),14 patients undergoing uteral myectomy in a head down position (Group M), and 8 patients undergoing cholecystectomy in a head up position (Group C). Peak inspiratory pressure (PIP), endexpiratory pressure (PEEP), respiratory compliance (Cdyn) measurements using side stream spirometry, endotidal CO2 (PetCO2), arterial oxygen saturation (SaO2) and pressure of pneumoperitoneum were measured. The measurements were performed in 3 periods: a) before pneumoperitoneum or lifting, b) after 5 minutes and c) after 30 minutes. PIP was increased and Cdyn was decreased in all groups. PetCO2 was increased in Groups H and C. Changes in Cdyn in Group M were less than those in Groups H and C after 5 minutes. A decrease in Cdyn after 30 minutes in Group H was higher than that in Groups C and M. It needs to be well recognized that pneumoperitoneum and head down position exacerbate the adverse effects on respiratory mechanics. (author abst.)
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