The Effects of Positive End-Expiratory Pressure at Different Levels on Postoperative Respiration Parameters in Patients Undergoing Laparoscopic Cholecystectomy.
Purpose/Aim of the study: We investigated the effects of different positive end-expiratory pressure (PEEP) levels on postoperative respiration parameters in patients undergoing laparoscopic cholecystectomy.


METHODS
One hundred and five consecutive patients were randomly divided to three groups (n = 35, for each group). Group I did not receive PEEP whereas group II received PEEP as 5 cmH2O and group III received PEEP as 8 cm H2O. Measurements with spirometer were taken 1 hour before the operation (T1) and, 1 (T2), 6 (T3), and 24 hours (T4) after extubation by an anesthetist. Forced expiratory volume (FEV1), forced vital capacity (FVC), and peak expiratory flow (PEF) were recorded.


RESULTS
Group I had higher FVC values measured at T2time point compared with other groups (p < 0.05, for both groups). There was a statistically significant difference between group I and group III in terms of the FVC values measured at T3and T4time points (p = 0.05 and p < 0.05, retrospectively). A statistical difference was found between group I and group II in terms of FEV1measured at T2time point (p < 0.05). Group I had higher FEV1values measured at T3and T4time points compared to group III (p = 0.05, P<0.05; respectively). Group III had lower PEF values measured at T4time point compared to group I and II (p < 0.05).


CONCLUSIONS
We concluded that PEEP with 5 or 8 cmH2O has negative effects on lung function tests measured with spirometer during postoperative 1st, 6th, and 24thhours in patients underwent elective laparoscopic cholecystectomy.
a Department of Anaesthesiology and Reanimation, Faculty of Medicine , Ataturk University , Erzurum , Turkey.
Bahadır
B
Ciftci
a Department of Anaesthesiology and Reanimation, Faculty of Medicine , Ataturk University , Erzurum , Turkey.
Mehmet
M
Aksoy
a Department of Anaesthesiology and Reanimation, Faculty of Medicine , Ataturk University , Erzurum , Turkey.
Ilker
I
Ince
a Department of Anaesthesiology and Reanimation, Faculty of Medicine , Ataturk University , Erzurum , Turkey.
Ali
A
Ahıskalıoglu
b Department of Pulmonary Diseases , Faculty of Medicine , Ataturk University , Erzurum , Turkey.
Elif
E
Yılmazel Ucar
D000328:Adult; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D017558:Elective Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011175:Positive-Pressure Respiration / Q000009:adverse effects*; D011184:Postoperative Period; D011446:Prospective Studies; D012119:Respiration; D012129:Respiratory Function Tests; D016896:Treatment Outcome
general anesthesia; laparoscopic cholecystectomy; positive end-expiratory pressure; respiratory function tests; spirometry