- Turkish Journal of Medical Sciences
- Vol: 46 Issue: 4
- Comparison of the effects of PEEP levels on respiratory mechanics and elimination of volatile anesth...
Comparison of the effects of PEEP levels on respiratory mechanics and elimination of volatile anesthetic agents in patients undergoing laparoscopic cholecystectomy; a prospective, randomized, clinical trial
Authors : Hüsnü Mert Arinalp, Nurten Bakan, Gülşah Karaören, Ömer Torun Şahin, Emre Çeliksoy
Pages : 1071-1077
View : 17 | Download : 5
Publication Date : 9999-12-31
Article Type : Makaleler
Abstract :Background/aim: In laparoscopic procedures, intraabdominal carbon dioxide (CO2) insufflation can cause decreased compliance, increased airway resistance, and impaired ventilation-perfusion ratios. We aimed to investigate the effects of intraoperative positive end-expiratory pressure (PEEP) treatment on respiratory dynamics and elimination time of volatile anesthetic agents. Materials and methods: In the present study, 75 ASA I-II patients were randomized into 3 groups to receive 0 cmH2O PEEP (group I), 5 cmH2O PEEP (group II), or 8 cmH2O PEEP (group III). Hemodynamic parameters, peak and plateau inspiratory airway pressures (Ppeak, Pplateau), compliance values, the ratio of the fractions of inspired and expired concentration of sevoflurane (Fi/Fexp sevoflurane) at 1 MAC, times from 1 to 0.3 and 0.1 MAC and values for pulmonary function tests (PFT) were recorded. Results: Ppeak and Pplateau in group III were higher; compliance values in group I and the extent of reduction in postoperative forced vital capacity (FVC) in group III were lower than those in the other groups (P < 0.05). No significant difference was observed between the groups regarding times from 1 to 0.3 MAC and times from 0.3 to 0.1 MAC. Conclusion: It was found that 8 cmH2O PEEP increased compliance without clinically significant pulmonary deterioration and that 8 cmH2O PEEP led to less impairment in postoperative PFTs compared to 0 and 5 cmH2O PEEP but had no effect on sevoflurane elimination time.Keywords : Positive end-expiratory pressure, compliance, pulmonary elimination, sevoflurane, laparoscopy