Korean J Anesthesiol.  1993 Feb;26(1):137-140. 10.4097/kjae.1993.26.1.137.

Changes in Pulmanary Gas Exchange during General Anesthesia for Laparoscopic Cholecystectomy

• Choe IH
• Hong MG
• Kang H
• Kim HK
• Oh YS

• KMID: 2145957
• DOI: http://doi.org/10.4097/kjae.1993.26.1.137

Abstract

The recent development of laparoscopic cholecysteetomy has introduced the technique of laparoscopy to the general surgical operation. During this procedure, the deliberate pneumoperitoneum with carbon dioxide(CO2) insufflation in order to visualize better the abdominal viscera may causes some problems-hypercarbia, hypertension, pneumomediastinum, subcutaneous emphysema and cardiovascular impairment, We studied the changes of cardiovascular system and pulmonary gas exchanges clinically during general anesthesia for laparoscopic eholecystectomy in the 16 patients of Seoul National University Hospital. After induction of anesthsia, ventilation was controlled with tidal volume 10 ml/kg and respiration rate 10-15/min to maintain PaCO2 35 mmHg before insufflation of carbon dioxide. After measuring of control value of mean arterial pressure(MAP), heart rate(HR) and arterial blood gas analysis before insufflation of CO2, ventilation setting was not changed throughout the operation. MAP, HR, arterial blood gas analysis were measured at 30 min interval until the end of operation. The changes of MAP, HR and PaO2, throughout the operation are not statistically significant in comparison to control(preinsufflation) values. The PaCO2 was increased significantly by 8-10 mmHg in comparison to control values(p-value<0.01). In conclusion, minute ventilation should be corrected during general anesthesia for laparoscapic cholecysteetomy with CO2 insufflation according to continuous monitoring of end tidal CO2 and arterial carbon dioxide tension.

Keyword

Laparoscopic cholecystectomy; Carbon dioxide insufflation; Hypercarbia; Venti- lation

MeSH Terms

Anesthesia, General*
Blood Gas Analysis
Carbon
Carbon Dioxide
Cardiovascular System
Cholecystectomy, Laparoscopic*
Heart
Humans
Hypertension
Insufflation
Laparoscopy
Mediastinal Emphysema
Pneumoperitoneum
Respiratory Rate
Seoul
Subcutaneous Emphysema
Tidal Volume
Ventilation
Viscera
Carbon
Carbon Dioxide