Haseki Tıp Bülteni (Jun 2014)
Comparison of Pressure-Controlled Ventilation and Volume-Controlled Ventilation During Laparoscopic Cholecystectomy
Abstract
Aim: The study aimed to carry out a retrospective analysis of the effects of pressure-controlled and volume-controlled ventilation during laparoscopic cholecystectomy procedures performed between January 2011 and January 2013 on hemodynamics, respiratory mechanics and oxygenation. Methods: Data were mainly obtained from preoperative and intraoperative anaesthetic record files. Eighty-two patients, who had undergone laparoscopic cholecystectomy, were retrospectively studied. Group 1 (n=41) received pressure support for obtaining 8-9 mLkg-1 tidal volume with pressure-controlled ventilation, group 2 (n=41) received volume-controlled ventilation with a tidal volume of 8-9 mLkg-1, a respiratory rate of 12 breaths/min and a positive end-expiratory pressure (PEEP) of 5 cm H2O. Hemodynamic and respiratory parameters, which were measured preoperatively, after intubation in the supine position, 15 minutes after CO2 insufflation, and after desufflation, were recorded. Arterial blood gas analyses were recorded which were measured at the same time with hemodynamics and respiratory parameters and during the postanesthetic care period. Results: Systolic arterial pressure at the time of insufflation was higher in Group 2 than in group 1. There was no difference in EtCO2 levels between the groups. All times Ppeak and insufflation time Pplato levels were higher in group 2. Compliance at all periods was lower in group 2. Desufflation period Vd/Vt and P(A-a)O2 levels were higher in group 2. Post anaesthetic care PaO2 levels were higher in group 1. Conclusion: Pressure-controlled ventilation can be an alternative to volume-controlled ventilation during general anaesthesia to prevent and repair pneumoperitonium-related side-effects during laparoscopic cholecystectomy. (The Medical Bulletin of Haseki 2014; 52: 75-9)
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