title: The Effects of Volume-Controlled and Pressure-Controlled Ventilation on Lung Mechanics, Oxidative Stress, and Recovery in Gynecologic Laparoscopic Surgery.
abstract: OBJECTIVE
  To compare ventilation variables, changes in oxidative stress, and the quality of recovery in 2 different ventilation strategies (volume-controlled ventilation [VCV] and pressure-controlled ventilation [PCV]) during gynecologic laparoscopic surgery.
  
  
  METHODS
  A prospective randomized controlled trial (Canadian Task Force classification I).
  
  
  METHODS
  One university teaching hospital in Taiwan.
  
  
  METHODS
  Women scheduled for laparoscopic gynecologic surgery.
  
  
  METHODS
  Women were randomly assigned to receive either VCV or PCV during surgery.
  
  
  RESULTS
  Ventilation variables were recorded 1 minute before and 1 hour after pneumoperitoneum. Blood samples were collected for malondialdehyde measurement at 7 points: 1 minute before and 1 hour after pneumoperitoneum; 30, 60, 90, and 120 minutes after deflation; and 24 hours after surgery. Postoperative recovery was assessed by using a 9-item quality of recovery score at 24 hours after surgery. A total of 52 women randomly allocated to the VCV (n = 27) or PCV (n = 25) group completed the study. We found that after 1 hour of insufflation the PCV group had lower peak airway pressure (22.0 ± 3.4 vs 26.6 ± 4.1 cm H2O, p < .0001) and higher compliance (28.4 ± 3.7 vs 24.1 ± 3.3 mL/cm H2O, p < .0001) than the VCV group. In plasma levels of malondialdehyde, there were no significant differences between the 2 groups at 7 time points. The levels significantly increased in both groups after 1 hour of pneumoperitoneum and peaked at 2 hours after deflation. During postoperative recovery, lower scores were obtained at 24 hours after surgery compared with preoperative scores, but there were no significant differences between the 2 groups.
  
  
  CONCLUSIONS
  PCV is an alternative ventilation mode in gynecologic laparoscopic surgery. However, PCV offered lower peak airway pressure and higher compliance than VCV but no advantages over VCV in oxidative stress or quality of recovery.
authors.affiliation: Department of Anesthesiology, Chang Gung Memorial Hospital at Linkou and Chang Gung University College of Medicine, Kwei-Shan, Taoyuan, Taiwan.
authors.forename: Chia-Chih
authors.initials: CC
authors.lastname: Liao
authors.affiliation: Department of Anesthesiology, Chang Gung Memorial Hospital at Linkou and Chang Gung University College of Medicine, Kwei-Shan, Taoyuan, Taiwan.
authors.forename: Yi-Chuan
authors.initials: YC
authors.lastname: Kau
authors.affiliation: Department of Anesthesiology, Chang Gung Memorial Hospital at Linkou and Chang Gung University College of Medicine, Kwei-Shan, Taoyuan, Taiwan.
authors.forename: Pei-Chi
authors.initials: PC
authors.lastname: Ting
authors.affiliation: Department of Anesthesiology, Chang Gung Memorial Hospital at Linkou and Chang Gung University College of Medicine, Kwei-Shan, Taoyuan, Taiwan.
authors.forename: Shih-Chang
authors.initials: SC
authors.lastname: Tsai
authors.affiliation: Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital at Linkou and Chang Gung University College of Medicine, Kwei-Shan, Taoyuan, Taiwan. Electronic address: m7147@cgmh.org.tw.
authors.forename: Chin-Jung
authors.initials: CJ
authors.lastname: Wang
mesh_terms: D000328:Adult; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006439:Hemodynamics; D006801:Humans; D010535:Laparoscopy; D008315:Malondialdehyde / Q000378:metabolism*; D018384:Oxidative Stress; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000295:instrumentation / Q000379:methods*; D015656:Respiratory Mechanics; D011795:Surveys and Questionnaires; D013624:Taiwan; D016896:Treatment Outcome
chemical_list: D008315:Malondialdehyde
keywords: Laparoscopy; Oxidative stress; Pneumoperitoneum; Quality of recovery score; Reperfusion injury; Ventilation