Revista Brasileira de Anestesiologia (Aug 2020)

Impact of Grade I obesity on respiratory mechanics during video laparoscopic surgery: prospective longitudinal study

  • Orlandira Costa Araujo,
  • Eloisa Bonetti Espada,
  • Fernanda Magalhães Arantes Costa,
  • Julia Araujo Vigiato,
  • Maria José Carvalho Carmona,
  • José Pinhata Otoch,
  • João Manoel Silva Jr.,
  • Milton de Arruda Martins

DOI
https://doi.org/10.1016/j.bjane.2020.02.004
Journal volume & issue
Vol. 70, no. 2
pp. 90 – 96

Abstract

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Abstract Introduction and objectives: The association pneumoperitoneum and obesity in video laparoscopy can contribute to pulmonary complications, but has not been well defined in specific groups of obese individuals. We assessed the effects of pneumoperitoneum in respiratory mechanics in Grade I obese compared to non-obese. Methods: Prospective study including 20 patients submitted to video laparoscopic cholecystectomy, normal spirometry, divided into non-obese (BMI ≤ 25 kg.m-2) and obese (BMI > 30 kg.mg-2), excluding Grade II and III obese. We measured pulmonary ventilation mechanics data before pneumoperitoneum (baseline), and five, fifteen and thirty minutes after peritoneal insufflation, and fifteen minutes after disinflation (final). Results: Mean BMI of non-obese was 22.72 ± 1.43 kg.m-2 and of the obese 31.78 ± 1.09 kg.m-2, p 0.05). The same occurred with elastic pressure, higher in the obese at all times (GLM p = 0.04), and resistive pressure showed differences in variations between groups during pneumoperitoneum (GLM p = 0,05). Conclusions: Grade I obese presented more changes in pulmonary mechanics than the non-obese during video laparoscopies and the fact requires mechanical ventilation-related care.

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