Effects of pneumoperitoneal pressure on respiratory function and haemodynamic in laparoscopic cholecystectomy under general anesthesia

Objective To investigate the effects of different pneumoperitoneal pressure on respiratory function and haemodynamic in laparoscopic cholecystectomy under general anesthesia. Methods Sixty patients with cholelithiasis or gallbladder polpy, American Society of Anesthesiologists (ASA) gradeⅠ~Ⅱ, undergoing laparoscopic cholecystectomy, were randomly allocated into one of two groups: group H and L. patients in the two groups were induced with midazolam 0.1 mg/kg, fentanyl 4 ug/kg, propofol 1 mg/kg, vecuronium 0.1 mg/kg1, anesthesia maintained with inhaled isoflurane, intermittent intravenous fentanyl and vecuronium. Pneumoperitoneal pressure was controlled at (8±1) cmH2O in group H, and (12±1) cmH2O in group L. BP, Ppeak, PETCO2, PaO2, PaCO2, pH, SBE were observed and VCO2, A-aDO2, Pa-PETCO2 gradient were calculated before CO2 insufflation and 10, 20, 30 min after CO2 insufflation and 5min after deflation. Results In the two groups, SBP and DBP were higher and HR arised after CO2 insufflation than that before CO2 insufflation, and there was no signficant difference between the two groups. Ppeak, PETCO2, PaCO2, A-aDO2, SBE, VCO2 after insufflation were higer than that before insufflation, and higher in group H than in group L. Conclusion 12 cmH2O pneumoperitoneal pressure in laparoscopic cholecystectomy under general anesthesia. can increase the absorption and expiration of CO2, and has the danger of respiratory acidosis.