Korean J Anesthesiol.  2000 Jan;38(1):1-7. 10.4097/kjae.2000.38.1.1.

Comparison of the Effects of Propofol and Isoflurane Anesthesia on Respiratory Gas Exchange during Laparoscopic Cholecystectomy

• Kang WJ
• Park JW
• Kim KS
• Kim DO
• Choi YK
• Shin OY
• Lee DI
• Kwon MI
• Kim DS
• Shin KI

• KMID: 2091480
• DOI: http://doi.org/10.4097/kjae.2000.38.1.1

Abstract

BACKGROUND: Introduction of a pneumoperitoneum using CO2 is accompanied by significant alterations in respiratory function and pulmonary gas exchange during laparoscopic cholecystectomy. Previous studies have shown differing results concerning pulmonary gas exchange: a significant decrease of PaO2 was induced with isoflurane. In contrast, no significant changes were observed with propofol. The purpose of the present study was to compare the effects of propofol vs isoflurane on pulmonary gas exchange during general anesthesia for laparoscopic cholecystectomy.
METHODS
Forty patients were divided randomly between isoflurane and propofol groups. After induction of anesthesia, ventilation was controlled and intra-abdominal pressure was maintained automatically at 12 mmHg by a CO2 insufflator. After the measuring of baseline values of blood pressure, heart rate, PaO2, PaCO2 and PetCO2 before CO2 insufflation, measurements were also made immediately, 30min after CO2 insufflation and 5 min after CO2 exsufflation.
RESULTS
In the isoflurane group, PaCO2, PetCO2, PaO2, and P(a-et)CO2 changed significantly 30 min after CO2 insufflation and 5 min after CO2 exsufflation (P < 0.05). In the propofol group, PaCO2 and PetCO2 increased significantly 30 min after CO2 insufflation and 5 min after CO2 exsufflation (P < 0.05), but PaO2 and P(a-et)CO2 remained constant. When the two groups were compared, there were significant differences in PaO2, PaCO2, PetCO2 and P(a-et)CO2 at 30min after CO2 insufflation and 5 min after CO2 exsufflation (P < 0.05).
CONCLUSIONS
These results indicate that during laparoscopic cholecystectomy the PaO2 was significantly lower and PaCO2 and P(a-et)CO2 were significantly higher in the isoflurane group compared with the propofol group.

Keyword

Anesthetics, intravenous: propofol; Anesthetics, volatile: isoflurane; Lung: pulmonary function; respiratory gas exchange; Surgery: laparoscopic cholecystectomy

MeSH Terms

Anesthesia*
Anesthesia, General
Blood Pressure
Cholecystectomy, Laparoscopic*
Heart Rate
Humans
Insufflation
Isoflurane*
Pneumoperitoneum
Propofol*
Pulmonary Gas Exchange
Ventilation
Isoflurane
Propofol