Acid-base balance alterations in laparoscopic cholecystectomy.
BACKGROUND
The purpose of this study is to determine alterations of acid-base balance originated by pneumoperitoneum with CO2. Influence of other factors such as anesthetic technique, duration of procedure, and volume of CO2 insufflated has also been analyzed.


METHODS
Some 132 patients were divided in three groups according to anesthetic technique used. Arterial blood gases were determined before pneumoperitoneum, at 20 min after it, and every 30 min, until procedure's end, and in postoperative period up to a total of four samples.


RESULTS
Pneumoperitoneum originated a fall of pH (p << 0. 001), ion bicarbonate (p << 0.001), and base excess (p << 0.001) and an elevation of PaCO2 (p << 0.001). No correlation was found between these changes and duration of pneumoperitoneum or amount of CO2 insufflated. Changes were fundamentally of a metabolic type. There were no statistically significant differences among anesthetic techniques.


CONCLUSIONS
In conclusion, pneumoperitoneum with CO2 originates alterations of the acid-base balance, mostly of a metabolic type. This could mean that besides CO2 absorption, there is a tissular hypoperfusion due to the increase of abdominal pressure.
Gándara
V
V
Service Anesthesiology, General Hospital of Mostoles, Madrid, Spain.
de Vega
D S
DS
Escriú
N
N
Zorrilla
I G
IG
D000005:Abdomen / Q000502:physiology; D000136:Acid-Base Equilibrium; D000328:Adult; D000368:Aged; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011028:Pneumoperitoneum, Artificial; D011312:Pressure; D011446:Prospective Studies