Comparison of volume-controlled ventilation and pressure-controlled ventilation volume guaranteed during laparoscopic surgery in Trendelenburg position.
OBJECTIVE
To analyze the effects of pressure-controlled ventilation-volume guaranteed (PCV-VG) and volume controlled ventilation (VCV) on airway pressures and respiratory and circulatory indicators during laparoscopic surgery in Trendelenburg position.


METHODS
Prospective randomized comparative clinical study.


METHODS
Tertiary hospital.


METHODS
Forty ASA physical status 1 and 2 patients who underwent elective laparoscopic surgery in Trendelenburg position.


METHODS
Patients were randomly allocated to either VCV group (n=20) or the PCV-VG group (n=20). After induction of anesthesia, for both modes of ventilation, the target tidal volume (VT) was 8mL/kg and the respiratory rate was adjusted to avoid hypercarbia.


METHODS
The peak and mean inspiratory pressures, dynamic compliance, exhaled VT, oxygenation index and physiological dead space were calculated and recorded at T1, 5minutes after induction of anesthesia in supine position, T2, 5minutes after stabilization of pneumoperitoneum, T3 and T4, 15 and 60minutes after 30° Trendelenburg position with pneumoperitoneum respectively.


RESULTS
PCV-VG group had significantly lower peak inspiratory pressure and greater dynamic compliance than VCV group (P<.001).


CONCLUSIONS
In patients who underwent laparoscopic surgery in Trendelenburg position, PCV-VG was superior to VCV in its ability to provide ventilation with lower peak inspiratory pressure and greater dynamic compliance.
Department of Anesthesia, Faculty of Medicine, Cairo University, Cairo, Egypt. Electronic address: osamaasaad72@yahoo.com.
Osama M
OM
Assad
Department of Anesthesia, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Ayman A
AA
El Sayed
Department of Anesthesia, Faculty of Medicine, Cairo University, Cairo, Egypt.
Mohamed A
MA
Khalil
D000368:Aged; D001784:Blood Gas Analysis; D005260:Female; D018475:Head-Down Tilt / Q000009:adverse effects*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning / Q000009:adverse effects*; D011312:Pressure; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000379:methods*; D015656:Respiratory Mechanics; D013990:Tidal Volume
Laparoscopic surgery; Mechanical ventilation; Trendelenburg position