title: The role of ventilation mode using a laryngeal mask airway during gynecological laparoscopy on lung mechanics, hemodynamic response and blood gas analysis.
abstract: BACKGROUND
  There are two methods for ventilation in gynecological laparoscopy: volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV).
  
  
  OBJECTIVE
  To compare the lung mechanics, hemodynamic response and arterial blood gas analysis and gas exchange of two modes of VCV and PCV using laryngeal mask airway (LMA) at different time intervals.
  
  
  METHODS
  Sixty infertile women referred for diagnostic laparoscopy, based on ventilation mode, were randomly divided into two groups of VCV (tidal volume: 10 ml/kg) and PCV. In the PCV group, ventilation was initiated with a peak airway pressure (tidal volume: 10 ml/kg, upper limit: 35 cm H2O). In both groups, the arterial blood samples were taken in several time intervals (5, 10 and 15 min after LMA insertion) for blood gas evaluation. Also the lung mechanics parameters were continuously monitored and were recorded at different time intervals.
  
  
  RESULTS
  There were no significant differences for patient's age, weight, height and BMI in two groups. The peak and plateau airway pressure were significantly higher in VCV group compared to PCV group 5 and 10 min after insertion of LMA. PaO2was significantly higher after 10 and 15 min in VCV group compared to PCV group (p=0.005 and p=0.03, respectively). PaCO2showed significant increase after 5 min in PCV group, but the differences were not significant after 10 and 15 min in two groups. The end tidal CO2showed significant increase after 10 and 15 min in VCV compared to PCV group.
  
  
  CONCLUSIONS
  Both VCV and PCV seem to be suitable for gynecological laparoscopy. However, airway pressures are significantly lower in PCV compared to VCV.
authors.affiliation: Anesthesiology and Critical Care Department, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Mohammad Hossein
authors.initials: MH
authors.lastname: Jarahzadeh
authors.affiliation: Department of Anatomical Sciences, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
authors.forename: Iman
authors.initials: I
authors.lastname: Halvaei
authors.affiliation: Anesthesiology and Critical Care Department, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: Farshid
authors.initials: F
authors.lastname: Rahimi-Bashar
authors.affiliation: Anesthesiology and Critical Care Department, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Shekoufeh
authors.initials: S
authors.lastname: Behdad
authors.affiliation: Anesthesiology and Critical Care Department, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Rouhollah
authors.initials: R
authors.lastname: Abbasizadeh Nasrabady
authors.affiliation: Anesthesiology and Critical Care Department, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
authors.forename: Elahe
authors.initials: E
authors.lastname: Yasaei
keywords: Gynecologic laparoscopy; Laryngeal mask airway; Pressure controlled ventilation; Volume controlled ventilation