Document Detail

Influence of the patient positioning on respiratory mechanics during pneumoperitoneum.
MedLine Citation:
PMID:  12138516     Owner:  NLM     Status:  MEDLINE    
The aim of this study was to evaluate the effect of patient positioning during laparoscopic cholecystectomy on respiratory mechanics and arterial blood gases. Thirty patients of ASA I were included. Ventilation was controlled mechanically. Tidal volume and ventilator frequency were kept unchanged throughout the operation. Intra-abdominal pressure was kept constant at 12 mmHg. Ventrak respiratory system was used for measuring respiratory mechanics. The airway resistance (Raw), the dynamic compliance (Cdyn), and the peak inspiratory pressure (PIP) were monitored. Measurements were made in five intervals: "a" after induction of general anesthesia, "b" after insufflation, "c" in the Trendelenburg position of 40 degree, "d" in the Fowler position of 40 degree, and "e" after desufflation. Samples of arterial blood gases were collected while the respiratory mechanics were being recorded. The mean arterial pressure (MAP) and heart rate (HR) were also monitored. In our study, during intervals "c" and "d", PCO2, was increased and pH decreased. With the initiation of insufflation, Cdyn, PIP, and Rawx, were altered (P < 0.05). The patient positioning had a significant effect on respiratory mechanics. After desufflation only Cdyn changed (P < 0.05). Although HR remained in normal limits, MAP increased during pneumoperitoneum (P < 0.05). We conclude that blood gas changes and respiratory mechanics were affected by the duration of pneumoperitoneum and patient positioning. The Fowler position had the least influence on respiratory mechanics.
Ziya Salihoglu; Sener Demiroluk; Serpil Cakmakkaya; Emre Gorgun; Yildiz Kose
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Middle East journal of anaesthesiology     Volume:  16     ISSN:  0544-0440     ISO Abbreviation:  Middle East J Anaesthesiol     Publication Date:  2002 Jun 
Date Detail:
Created Date:  2002-07-25     Completed Date:  2002-12-24     Revised Date:  2014-10-10    
Medline Journal Info:
Nlm Unique ID:  8604187     Medline TA:  Middle East J Anaesthesiol     Country:  Lebanon    
Other Details:
Languages:  eng     Pagination:  521-8     Citation Subset:  IM    
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MeSH Terms
Blood Gas Analysis
Cholecystectomy, Laparoscopic
Hemodynamics / physiology
Middle Aged
Monitoring, Intraoperative
Pneumoperitoneum, Artificial / methods*
Posture / physiology*
Regional Blood Flow / physiology
Respiratory Mechanics / physiology*

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

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