| Objective To explore the effects of different mechanical ventilation methods to CO2 insufflation in patients undergoing retroperitoneoscopic surgery and discuss relatively reasonable ventilation methods to supply the clinical practice to reference.Methods 80 patients undergoing elective retroperitoneoscopic urologic surgery were randomly divided into 2 big groups: group A and group B , group A was younger than 59 years, and group B was older than 60 years. Then the two big groups were divided into 4 small groups randomly, The patients in group respectively were given the ventilation pattern of VT=10ml/kg,f=12bpm;VT=9ml/kg,f=13bpm;VT=8ml/kg,f=15bpm;VT=7ml/kg,f=17bpm, the groups were signed A1,A2,A3,A4,B1,B2,B3,B4 in turn. Arterial blood gas was measured to get PaCO2 and PaO2 at four time points :time before pneumoperitoneum, 20,40 and 60 min after pneumoperitoneum ,while the PETCO2,VD/VT,Ppeak,Pmean were observed at the same time and the Qs/Qt was calculated .Results In A group of comparison , no significant difference was found in the PaCO2,PETCO2,VD/VTand the Qs/Qt measured in the same time after pneumoperitoneum, the Ppeak and Pmeanobserved in the same time after pneumoperitoneum, A1>A2>A3, and no significant difference was founded between A3 and A4. In B group of comparison , Patients in B1 had the significantly lower PaCO2,PETCO2,VD/VT and Qs/Qt compared to the other three groups measured in the same time after pneumoperitoneum, the Ppeak and Pmean observed in the same time after pneumoperitoneum, B1>B2>B3, and no significant difference was found between B3 and B4.Conclusion In the premise that maintaining a minute ventilation volume under the 120ml/kg invariable, the middle-aged patient were suggested using the ventilation pattern of VT=8ml/kg,f=15bpm or VT=7ml/kg,f=17bpm. The old age patient were suggested that using the ventilation pattern of VT=10ml/kg,f=12bpm and was simultaneously needed to observe the change of airway pressure. |
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