Effects of pneumoperitoneum on tracheal carina position under a variety of peritoneum pressure

Objective To evaluate the effects of pneumoperitoneum on tracheal carina position.Methods Fifth-five patients undergoing laparoscopic cholecystectomy were studied. The distances from carina to the tip of the endotracheal tube were measured under the supine and Trendelenburg's position with zero,10,15mmHg pneumoperitoneum pressure.Results The distances were (4.59±1.66)cm(supine position), (4.51±1.56)cm (Trendelenburg's position) without pneumoperitoneum and (3.51±1.62)cm (supine position),(3.44±1.58)cm (Trendelenburg's position) under 10mmHg pneumoperitoneum and (3.45±1.64)cm (supine position), (3.42±1.59)cm (Trendelenburg's position) under 15mmHg pneumoperitoneum. There were no significant difference in the distances without pneumoperitoneum (P0.05). The distances were significantly shorter under 10mmHg and 15mmHg pneumoperitoneum compared with normal peritoneum pressure(P0.01). Endobronchial intubation were observed after pneumoperitoneum in three patients.Conclusions Pneumoperitoneum may produce cephalad movement of the carnia toward the relatively fixed endotrachealtube. We should properly decrease the length of tracheal intubation.