Utilización de la presión positiva en el pre- y en el intraoperatorio de cirugía bariátrica y sus efectos sobre el tiempo de extubación

Background and objective

To investigate the influence of intraoperative and preoperative airway positive pressure in the time of extubation in patients undergoing bariatric surgery.

Method

Randomized clinical trial, in which 40 individuals with a BMI between 40 and 55 kg/m², age between 25 and 55 years, nonsmokers, underwent bariatric surgery type Roux-en-Y gastric bypass by laparotomy and with normal preoperative pulmonary function were randomized into the following groups: G-pre (n = 10): individuals who received treatment with noninvasive positive pressure before surgery for one hour, G-intra (n = 10): individuals who received PEEP of 10 cm H₂O throughout the surgical procedure and G-control (n = 20): not received any pre or intraoperative intervention. Following were recorded: time between induction of anesthesia and extubation, between the end of anesthesia and extubation, duration of mechanical ventilation, and time between extubation and discharge from the post-anesthetic recovery.

Results

There was no statistical difference between groups. However, when applied to the Cohen coefficient, the use of PEEP of 10 cm H₂O during surgery showed a large effect on the time between the end of anesthesia and extubation. About this same time, the treatment performed preoperatively showed moderate effect.

Conclusion

The use of PEEP of 10 cm H₂O in the intraoperative and positive pressure preoperatively, influenced the time of extubation of patients undergoing bariatric surgery.