Document Detail

Arterial to end-tidal carbon dioxide pressure difference during laparoscopic surgery in pregnancy.
MedLine Citation:
PMID:  10910483     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: There is controversy about whether capnography is adequate to monitor pulmonary ventilation to reduce the risk of significant respiratory acidosis in pregnant patients undergoing laparoscopic surgery. In this prospective study, changes in arterial to end-tidal carbon dioxide pressure difference (PaCO2--PetCO2), induced by carbon dioxide pneumoperitoneum, were determined in pregnant patients undergoing laparoscopic cholecystectomy. METHODS: Eight pregnant women underwent general anesthesia at 17-30 weeks of gestation. Carbon dioxide pnueumoperitoneum was initiated after obtaining arterial blood for gas analysis. Pulmonary ventilation was adjusted to maintain PetCO2 around 32 mmHg during the procedure. Arterial blood gas analysis was performed during insufflation, after the termination of insufflation, after extubation, and in the postoperative period. RESULTS: The mean +/- SD for PaCO2--PetCO2 was 2.4 +/- 1.5 before carbon dioxide pneumoperitoneum, 2.6 +/- 1.2 during, and 1.9 +/- 1.4 mmHg after termination of pneumoperitoneum. PaCO2 and pH during pneumoperitoneum were 35 +/- 1.7 mmHg and 7.41 +/- 0.02, respectively. There were no significant differences in either mean PaCO2--PetCO2 or PaCO2 and pH during various phases of laparoscopy. CONCLUSIONS: Capnography is adequate to guide ventilation during laparoscopic surgery in pregnant patients. Respiratory acidosis did not occur when PetCO2 was maintained at 32 mmHg during carbon dioxide pneumoperitoneum.
K Bhavani-Shankar; R A Steinbrook; D C Brooks; S Datta
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anesthesiology     Volume:  93     ISSN:  0003-3022     ISO Abbreviation:  Anesthesiology     Publication Date:  2000 Aug 
Date Detail:
Created Date:  2000-09-06     Completed Date:  2000-09-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  370-3     Citation Subset:  AIM; IM    
Departments of Anesthesia and Surgery, Harvard Medical School, Brigham and Women's Hospital, Boston, MA 02115, USA.
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MeSH Terms
Analysis of Variance
Anesthesia, General
Pneumoperitoneum / metabolism*
Pregnancy Complications / surgery*
Prospective Studies
Pulmonary Gas Exchange*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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