A randomized, prospective comparison of end-tidal CO2 pressure during laparoscopic cholecystectomy in low and high flow anesthetic system.

Acta anaesthesiologica Sinica Pub Date : 2003-03-01
Parvin Sajedi, Khosrou Naghibi, Hassanali Soltani, Ahmad Amoshahi
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Abstract

Background: Low flow anaesthesia has been used in anesthetic practice to prevent operation room pollution and also for econormical reasons. Since the safety of low flow technique has not been clearly determined in previous researches this study was performed to compare the end-tidal CO2 pressure during laparoscopic cholecystectomy in low flow as opposed to high flow anesthesia.

Methods: Forty patients, 30-65 years of age, ASA physical status I or II, scheduled for laparoscopic cholecystectomy under general anesthesia were randomly alloted to low flow and high flow groups. End-tidal CO2 pressure, arterial blood pressure, pulse oximetric oxygen saturation, and heart rate were measured before, during and after insufflation of CO2 into the peritoneal cavity. The data were compared between two groups.

Results: Pneumoperitoneum caused a decrease in PaO2 and oxygen saturation together with increases in PaCO2 and end-tidal CO2 pressure in both groups but the differences between two groups were not statistically significant.

Conclusions: The result of this study shows that end-tidal CO2 pressure during laparoscopic cholecystectomy using low flow anesthesia system is comparable to that with high flow system. Therefore it can be concluded that low flow anesthesia can be used with relative safety in anesthetic management of patients during laparoscopic cholecystectoy.

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低流量和高流量麻醉系统下腹腔镜胆囊切除术时潮末CO2压力的随机、前瞻性比较。
背景:低流量麻醉已被用于麻醉实践,以防止手术室污染,也为经济原因。由于以往的研究并未明确确定低流量技术的安全性,因此本研究比较了低流量麻醉和高流量麻醉下腹腔镜胆囊切除术时的末潮CO2压力。方法:40例30 ~ 65岁,ASA身体状态I、II级的全麻腹腔镜胆囊切除术患者,随机分为低流量组和高流量组。在向腹腔内注入二氧化碳之前、期间和之后,分别测量潮末CO2压、动脉血压、脉搏血氧饱和度和心率。比较两组数据。结果:气腹使两组患者PaO2、氧饱和度降低,PaCO2、尾潮CO2压升高,但两组间差异无统计学意义。结论:本研究结果显示,低流量麻醉系统与高流量麻醉系统腹腔镜胆囊切除术时的末潮CO2压力相当。因此,低流量麻醉在腹腔镜胆囊切除术患者的麻醉管理中是相对安全的。
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