Effects of CO_2 pneumoperitoneum on circulation and respiration in elderly patients with laparoscopic cholecystectomy

Objective To observe the effects of CO2 pneumoperitoneum on circulation and respiration in elderly patients with laparoscopic cholecystectomy.Methods A total of 136 patients with laparoscopic cholecystectomy in our hospital were selected from August 2010 to February 2011.After anesthesia all the patients were given an injection of CO2 gas into abdominal cavity at a speed of 1-2 L/min to maintain the pneumoperitoneum pressure at 8-12 mmHg.The parameters,such as heart rate(HR),systolic blood pressure(SBP),diastolic blood pressure(DBP),oxygen saturation(SpO2),end-tidal CO2 partial pressure(petCO2) and peak inspiratory pressure(Ppeak) were measured before pneumoperitoneum,at 5,15 and 30 min after pneumoperitoneum,and at 5,15 min after deflation.The central venous pressure(CVP) and arterial blood gas(ABG) were monitored in some cases.Results Compared with those before pneumoperitoneum,petCO2 and Ppeak significantly increased at 5,15 and 30 min after pneumoperitoneum(P0.01);HR,SBP,DBP and CVP increased too(P0.05).Arrhythmia occurred in 78.5% of the patients,most presenting as supraventricular tachycardia(SVT) and premature ventricualr contraction(PVC).PaCO2 increased at 15 and 30 min after pneumoperitoneum compared with that before pneumoperitoneum(P0.01).The pH of blood decreased significantly(P0.05)and was less than 7.35 in 19.2% patients at 15 min after deflation.Conclusion For elderly patients,the circulation and respiration were easily affected by CO2 pneumoperitoneum.The effective intervention should be taken to reduce its occurrence during operation.