[Changes of arterial CO2 (PaCO2) and urine output by carbon dioxide insufflation of the peritoneal cavity during laparoscopic cholecystectomy].
We studied on the effects of carbon dioxide insufflation during laparoscopic cholecystectomy on the arterial blood gas analysis and urine output. Intra-abdominal pressure was increased up to either 10cmH2O or 15cmH2O, and we compared the PaCO2 values before and during insufflation. Both increase of PaCO2 and decrease in pH were larger in intra-abdominal pressure of 15cmH2O than 10cmH2O. In the intra-abdominal pressure 15cmH2O group, the increase of PaCO2 by CO2 peritoneal insufflation was significantly larger in operative time of more than 60 minutes group than in less than 60 minutes group, but no significant changes were observed in 10cmH2O group. In the group of obesity index of more than 120, elevation levels of PaCO2 by CO2 insufflation were significant, but in the group of less than 120 no significant elevation were observed. The tendency that the urine output during operation was decreased as increase of intra-abdominal pressure or operative time, but the obesity had no definite effects on urine output. Insufflation of the abdomen with CO2 caused large changes in PaCO2 or pH in the patients with a previous history of major cardiopulmonary disorder. It was shown that the low insufflation pressure and short operative time is good for the maintenance of normal physiological state.
Wakizaka
Y
Y
Department of Surgery, Sapporo City Hospital, Japan.
Sano
S
S
Koike
Y
Y
Nakanishi
Y
Y
Uchino
J
J
D000328:Adult; D000368:Aged; D002245:Carbon Dioxide / Q000097:blood*; D017081:Cholecystectomy, Laparoscopic / Q000379:methods; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007327:Insufflation / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000652:urine; D010313:Partial Pressure; D010529:Peritoneal Cavity; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects; D014556:Urine
D002245:Carbon Dioxide