Anesth Pain Med.  2009 Jan;4(1):55-59.

A comparison of transcutaneous and end-tidal measurements of CO2 tension in laparoscopic surgery

• Choi HR
• Lim YH
• Park HG
• Lee S
• Yon JH
• Hong KH

Abstract

BACKGROUND: In laparoscopic surgery with pneumoperitoneum, end-tidal CO2 (PeTCO2) monitoring may inaccurately estimate PaCO2 due to ventilation/perfusion mismatch. This study assessed the clinical usefulness and accuracy of transcutaneous CO2 (PtCCO2) monitoring during laparoscopic surgery.
METHODS
Thirty-two patients with ASA physical status 1 requiring laparoscopic surgery were recruited. We measured PaCO2, PeTCO2, and PtCCO2 before and 20 min after pneumoperitoneum. To compare differences in PeTCO2/PaCO2 and PtCCO2/PaCO2, we determined bias values (mean difference between values) and precision (standard deviation of bias) with a Bland-Altman plot and compared them with a Student's t-test.
RESULTS
Bias and precision values of PeTCO2/PaCO2 and PtCCO2/PaCO2 were 6.6 +/- 2.0 mmHg, 1.2 +/- 2.8 mmHg before pneumoperitoneum and 8.5 +/- 2.8 mmHg, 2.1 +/- 4.5 mmHg 20 min after pneumoperitoneum. PtCCO2/PaCO2 differences were significantly smaller than PeTCO2/PaCO2 differences (P< 0.05).
CONCLUSIONS
In laparoscopic surgery, PtCCO2 monitoring is more accurate than PeTCO2 monitoring for assessing PaCO2 levels.

Keyword

carbon dioxide; laparoscopic surgery; monitoring; transcutaneous

MeSH Terms

Bias (Epidemiology)
Carbon Dioxide
Humans
Laparoscopy
Pneumoperitoneum
Carbon Dioxide