A PROSPECTIVE, RANDOMIZED STUDY TO ASSESS THE EFFECT OF PNEUMOPERITONEUM ON ARTERIAL AND ENDTIDAL CARBONDIOXIDE PRESSURE GRADIENT DURING LAPAROSCOPIC SURGERY IN ADULTS

Dr. Uma Maheshwari. P; Dr.Sugantha. R

Volume : X, Issue : II, February - 2020

A PROSPECTIVE, RANDOMIZED STUDY TO ASSESS THE EFFECT OF PNEUMOPERITONEUM ON ARTERIAL AND ENDTIDAL CARBONDIOXIDE PRESSURE GRADIENT DURING LAPAROSCOPIC SURGERY IN ADULTS

Dr. Uma Maheshwari. P, Dr. Sugantha. R

Abstract :

BACKGROUND:To assess the effects of pneumoperitoneum on arterial and end tidal carbondioxide pressure gradient during laparoscopic surgery in adults . METHODOLOGY: Sixty, ASA 1&2 patients between 20 to 60 years posted for elective laparoscopic appendicectomy or cholecystectomy were selected . Intra abdominal pressure was maintained between 10–12 mmHg. Preinsufflation of CO2 and intra operatively 15 minutes after insufflation ABGs were analysed. The changes in PaCO2 ,ETCO2 , P(a–Et)CO2 gradient ,PH, bicarbonate and hemodynamic changes were studied. CONCLUSION:There was significant increase in ETC02 ,PaCO2, P(a–Et)CO2 gradient, after CO2 insufflation but within normal range. There was decrease in pH without bicarbonate change with slight increase in heart rate and diastolic blood pressure. The arterial and ETCO2 pressure gradients were under the normal limits even after pneumoperitoneum. The normal pressure P(a–Et)CO2 gradient implies adequate ventilation to alveoli and perfusion . ETCO2 correlate well with PaCO2 as best parameter to diagnose hypercarbia.