The Effect of Cardiovascular and Arterial Blood Gas Changes during Laparoscope Assisted Vaginal Hysterectomy (LAVH)

Kim, Woon Young; Lim, Hae Ja; Yoon, Suk Min; Park, Young Chul

Abstract

In the last decade, advances in laparoscopic equipments have allowed the development of laparoscopic surgical treatment for gynecologic affeetion. The purpose of this study is to investigate the cardiovascular effects and blood gas changes during laparoscope assisted vaginal hysterectomy (LAVH) in Trendelenburg position and intraabdominal CO2 insufflation to obtain optimal surgical field. Mean arterial pressure (MAP), heart rate. SaO2, PaO2, end-tidal CO2 (ETCO2) PaCO2, pH, and peak airway pressure (PAP) were measured in twenty patients who underwent laparoscope assisted vaginal hysterectomy in Trendelenburg position and intraabdominal CO2 insufflation. Each measurement was taken immedistely after intubation (control), 15 minutes after Trendelenburg position, 30 minutes after CO2 insufflation, 15 minutes, 1 hour and 6 hrs. after CO2 deflation. ETCO2 and PAP were not measured 1 hour and 6 hrs. after deflation The results were as follows; 1) Mean arterial pressure and heart rate were decreased after Trendelenburg position, but increased after CO2 insufflation. 2) Arterial O2 saturation was decreased after CO2 insufflation, 1 hour after deflation 3) Arterial PO2 was decreased after CO2 insufflation. 4) End-tidal CO2 was increased after CO2 insufflation. 5) Arterial PCO2 was increased after CO2 insufflation compared to control value, but it was decreased at 15 minutes after CO2 deflation. Arterial PCO2 at 1 hour after CO2 deflation was higher than at 15 minutes after CO2 deflation and 6 hrs. after CO2 deflation. 6) Arterial pH was decreased after CO2 insufflation. 7) Peak airway pressure was increased after Trendelenburg position and after CO2 insufflation.