title: Hypercapnia during transperitoneal and retroperitoneal endoscopic spinal surgery: a prospective study.
abstract: 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.
authors.affiliation: 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
authors.forename: J P
authors.initials: JP
authors.lastname: Estèbe
authors.forename: E
authors.initials: E
authors.lastname: Ternisien
authors.forename: J L
authors.initials: JL
authors.lastname: Polard
authors.forename: A
authors.initials: A
authors.lastname: Lenaoures
authors.forename: M
authors.initials: M
authors.lastname: Leroy
authors.forename: J L
authors.initials: JL
authors.lastname: Husson
authors.forename: C
authors.initials: C
authors.lastname: Ecoffey
mesh_terms: 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
chemical_list: D002245:Carbon Dioxide