Hypercapnia during transperitoneal and retroperitoneal endoscopic spinal surgery: a prospective study.
OBJECTIVE
To evaluate the effect of carbon dioxide (CO(2)) pneumoperitoneum and retropneumoperitoneum insufflation on CO(2) excretion.


METHODS
Prospective study.


METHODS
Operating room and recovery room in a teaching hospital.


METHODS
29 patients scheduled for orthopedic spine fusion surgery.


METHODS
Patients received either transperitoneal insufflation (n = 12) or retroperitoneal insufflation (n = 17).


RESULTS
Increases in the partial pressure of end-tidal CO(2) (PetCO(2)) and arterial CO(2) tension (PaCO(2)) during retropneumoperitoneum exceeded those obtained during pneumoperitoneum. Furthermore, PetCO(2) increased faster during retroperitoneum and did not reach a plateau. Finally, 76% of the patients in this group required ventilatory adjustment due to high PetCO(2) levels.


CONCLUSIONS
This study may focus attention on the need for continuous ventilatory adjustments during transperitoneal endoscopic surgery.
Estèbe
J P
JP
Department of Anaesthesia and Intensive Care, Pain Clinic, University of Rennes, Hôpital Hôtel Dieu, 2 Rue de l'Hôtel Dieu, 35000 Rennes, France. jean-pierre.estebe@chu-rennes.fr
Ternisien
E
E
Polard
J L
JL
Lenaoures
A
A
Leroy
M
M
Husson
J L
JL
Ecoffey
C
C
D000142:Acidosis, Respiratory / Q000209:etiology; D002245:Carbon Dioxide / Q000008:administration & dosage* / Q000097:blood / Q000502:physiology; D004724:Endoscopy; D006801:Humans; D006935:Hypercapnia / Q000209:etiology*; D007431:Intraoperative Complications / Q000209:etiology; D008159:Lumbar Vertebrae / Q000601:surgery; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects*; D011446:Prospective Studies; D012119:Respiration; D012187:Retroperitoneal Space; D012447:Sacrum / Q000601:surgery; D013123:Spinal Fusion
D002245:Carbon Dioxide