| The Effects of Increased Abdominal Pressure on Respiratory System Compliance during Laparoscopic Cholecystectomy. |
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Sang Yoon Cho, Jeong Uk Han, Jong Hoon Yeom, Woo Jong Shin, Yong Chul Kim, Dong Ho Lee, Hwon Kyum Park |
1Departments of Anesthesiology, College of Medicine, Hanyang University, Kuri.
2Departments of General Surgery, College of Medicine, Hanyang University, Kuri.
3Department of Anesthesiology, College of Medicine, Inha University, Incheon, Korea. |
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| Abstract |
BACKGROUND
We examined whether increases of intra-abdominal pressure would decrease compliance (C) of both lung and chest wall.
METHODS
We measured airway and esophageal pressure in 10 anesthetized/paralyzed tracheally intubated patients during mechanical ventilation at the respiratory rate of 10 freq/min and the tidal volume of 10 ml/kg undergoing laparoscopic cholecystectomy. Measurements were made at 0 mmHg intra- abdominal pressure the (Pab) in supine position and at 15 mmHg Pab in 10 head-up (reverse Trendelenburg) position at 0, 5, 10 and 15 min. after CO2 insufflation.
RESULTS
We found that abdominal carbon dioxide insufflation caused a marked increase in peak airway pressure, plateau pressure and esophageal pressure (p<0.05); a reduction in compliance of respiratory system and chest wall (p<0.05).
CONCLUSION
These changes should be considered in patients such as those with pulmonary disease, undergoing laparoscopic cholecystectomy where increase in impendance may be critical. |
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