Korean J Anesthesiol.  2001 Apr;40(4):489-495. 10.4097/kjae.2001.40.4.489.

Effects of Insufflation on Hemodynamics and Arterial Blood Gas during Thoracoscopic Surgery

• Kim MH
• Kim JM
• Kim AR
• Cheun JK

• KMID: 2091600
• DOI: http://doi.org/10.4097/kjae.2001.40.4.489

Abstract

BACKGROUND: To visualize adequately the intrathoracic structures, creation of an artificial pneumothorax by carbon dioxide (CO2) insufflation under positive pressures has been advocated during thoracoscopic surgery. We hypothesized that positive-pressure insufflation during thoracoscopy would cause significant hemodynamic and ventilatory compromise.
METHODS
Thirty patients underwent general anesthesia with a single lumen endotracheal tube and placement of an arterial line. Noninvasive cardiac output monitoring was done on both the side of the neck and chest. Baseline measurements of hemodynamic indices and arterial blood gas analysis (ABGA) were taken before CO2 insufflation. Data was obtained at 5 minutes after CO2 insufflation. ABGA was taken 5 minutes after CO2 deflation.
RESULTS
Insufflation of CO2 resulted in an increase in heart rate (HR), mean arterial pressure (MAP), and systemic vascular resistance index (SVRI). Whereas cardiac index (CI), accelerated contractility index (ACI), PH, and arterial oxygen saturation (SaO2) were decreased.
CONCLUSIONS
Positive pressure insufflation of CO2 during thoracoscopy resulted in hemodynamic and arterial blood gas changes. Therefore, we propose that low pressure (< 10 mmHg) insufflation is a safe adjunct to routine thoracoscopic surgical procedures.

Keyword

Monitoring: arterial blood gas; noninvasive cardiac output; Surgery: thoracoscopy

MeSH Terms

Anesthesia, General
Arterial Pressure
Blood Gas Analysis
Carbon Dioxide
Cardiac Output
Heart Rate
Hemodynamics*
Humans
Hydrogen-Ion Concentration
Insufflation*
Neck
Oxygen
Pneumothorax, Artificial
Thoracoscopy*
Thorax
Vascular Access Devices
Vascular Resistance
Carbon Dioxide
Oxygen