Transcutaneous carbon dioxide monitoring accurately predicts arterial carbon dioxide partial pressure in patients undergoing prolonged laparoscopic surgery.
BACKGROUND
There may be large differences between measurements of end-tidal carbon dioxide partial pressure (Petco(2)) and arterial carbon dioxide partial pressure (Paco(2)) during laparoscopic surgeries. Transcutaneous carbon dioxide (Ptcco(2)) monitoring can be used to noninvasively and continuously estimate Paco(2). In the present study we evaluated the accuracy of Ptcco(2) monitoring in predicting the Paco(2) during laparoscopic surgeries with prolonged pneumoperitoneum.


METHODS
Sixteen patients who underwent laparoscopic radical gastrectomy or radical proctectomy under general anesthesia were included in the study. Their Paco(2), Petco(2), and Ptcco(2) values were measured at 3 time points before and after pneumoperitoneum. Agreement among measures was assessed by the Bland-Altman method.


RESULTS
Forty-eight sample sets were obtained. The average Paco(2)- Ptcco(2) difference was -0.9 + or - 6.4 mm Hg (mean + or - 2 SD). The average Paco(2) - Petco(2) difference was 7.5 + or - 7.0 mm Hg (mean + or - 2 SD). Paco(2) - Ptcco(2) was less than or equal to + or -5 mm Hg for 88% of the samples. Paco(2) - Petco(2) was less than or equal to + or -5 mm Hg for 17% of the samples (P < 0.05).


CONCLUSIONS
While undergoing long-term pneumoperitoneum laparoscopic surgery, Ptcco(2) monitoring is more accurate than is PETCO(2) monitoring in predicting the patients' Paco(2).
Xue
Qingsheng
Q
Department of Anesthesiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, 197#, No. 2 Ruijin Road, Shanghai 200025, P. R. China.
Wu
Xiaowen
X
Jin
Jue
J
Yu
Buwei
B
Zheng
Minhua
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000768:Anesthesia, General; D015415:Biomarkers / Q000097:blood; D001785:Blood Gas Monitoring, Transcutaneous; D002245:Carbon Dioxide / Q000097:blood*; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D010313:Partial Pressure; D011028:Pneumoperitoneum, Artificial; D011237:Predictive Value of Tests; D011468:Prostatectomy / Q000379:methods*; D015203:Reproducibility of Results; D013997:Time Factors
D015415:Biomarkers; D002245:Carbon Dioxide