Effects Of CO₂ Insufflation On Arterial Blood Gas In Laparoscopic Surgery And Retroperitoneal Laparoscopic Surgery

Objective:To explore the effects of CO2 insufflation on arterial blood gas in laparoscopic surgery and retroperitoneal laparoscopic surgery under general anesthesia, which surgery produces more effects on the patients's arterial blood gas and hypercapnia easier.Methods:One hundred patients with American Society of Anesthesiologists (ASA) gradeâ… -â…¡under general anesthesia. Fifty patients underwent elective retroperitoneoscopic urologic surgery(group A) and others underwent laparoscopic general or gynecological surgery (group B). In group A, male 26 cases and female 24 cases, age ranging from 21 to 56 years; In group B, male 22 cases and female 28 cases, age ranging from 22 to 56 years. Radial artery catheter were placed to moniter arterial blood gas. PH, PaCO2 and PaO2 were measured at four time points:time before CO2 insufflation,30 and 60 minutes after insufflation,30 minnutes after exsufflation.Results:The difference has no statistic significant in age and the time of insufflation(P>0.05). In the two groups and between the two groups, pH was decreased and PaCO2 increased significantly(P<0.05) at 30 and 60 minutes after insufflation. The rate of hypercapnia is 8%(4/50) in laparoscopic surgery and hypercapnia is 28%(14/50) in retroperitoneoscopic urologic surgery 30 minnutes after exsufflation. The rate of hypercapnia is 44%(22/50) in laparoscopic surgery and hypercapnia is 76%(38/50) in retroperitoneoscopic urologic surgery 60 minnutes after exsufflation. The difference has statistic significant(P<0.05).Conclusion:Retroperitoneal CO2 insufflation produces more effects on the patients's arterial blood gas, the rate of hypercapnia is higher in retroperitoneoscopic urologic surgery. Special attention should be paid to respiration administration and arterial blood gas monitoring. According to the changes in arterial blood gas, as soon as regulate breathing machine's parameters to increase minute ventilation, such as increase respiratory rate, hyperventilation, choose a suitable suction or call ratio, increase the minute ventilation to increase the respiratory frequency-based. When necessary, end-expiratory pressure ventilation to rid the body of excess CO2 as well as extension of extubation time.