title: A comparison between volume-controlled ventilation and pressure-controlled ventilation in providing better oxygenation in obese patients undergoing laparoscopic cholecystectomy.
abstract: BACKGROUND
  The maintenance of oxygenation is a commonly encountered problem in obese patients undergoing laparoscopic cholecystectomy. There is no specific guideline on the ventilation modes for this group of patients. Although several studies have been performed to determine the optimal ventilatory settings in these patients, the answer is yet to be found. The aim of this study was to evaluate the efficacy of pressure-controlled ventilation (PCV) in comparison with volume-controlled ventilation (VCV) for maintaining oxygenation during laparoscopic cholecystectomy in obese patients.
  
  
  METHODS
  One hundred and two adult patients of ASA physical status I and II, Body Mass Index of 30-40 kg/m(2), scheduled for laparoscopic cholecystectomy were included in this prospective randomized open-label parallel group study. To start with, all patients received VCV. Fifteen minutes after creation of pneumoperitoneum, they were randomized to receive either VCV (Group V) or PCV (Group P). The ventilatory parameters were adjusted accordingly to maintain the end-tidal CO(2) between 35 and 40 mmHg. Respiratory rate, tidal volume, minute ventilation and peak airway pressure were noted. Arterial blood gas analyses were done 15 min after creation of pneumoperitoneum and at 20-min intervals thereafter till the end of the surgery. All data were analysed statistically.
  
  
  RESULTS
  Patients in Group P showed a statistically significant (P < 0.05) higher level of PaO(2) and lower value of PAO(2)-PaO(2) than those in Group V.
  
  
  CONCLUSIONS
  PCV is a more effective mode of ventilation in comparison with VCV regarding oxygenation in obese patients undergoing laparoscopic cholecystectomy.
authors.affiliation: Department of Anaesthesiology, Institute of Post Graduate Medical Education and Research, Kolkata, India.
authors.forename: Sampa Dutta
authors.initials: SD
authors.lastname: Gupta
authors.forename: Sudeshna Bhar
authors.initials: SB
authors.lastname: Kundu
authors.forename: Tapas
authors.initials: T
authors.lastname: Ghose
authors.forename: Sunanda
authors.initials: S
authors.lastname: Maji
authors.forename: Koel
authors.initials: K
authors.lastname: Mitra
authors.forename: Maitreyee
authors.initials: M
authors.lastname: Mukherjee
authors.forename: Sripurna
authors.initials: S
authors.lastname: Mandal
authors.forename: Debabrata
authors.initials: D
authors.lastname: Sarbapalli
authors.forename: Sulagna
authors.initials: S
authors.lastname: Bhattacharya
authors.forename: Saikat
authors.initials: S
authors.lastname: Bhattacharya