Compare The Changes Of Blood Gas Analysis And Hemodynamic Between Laparoscopic Cholecystectomy And Resection Of The Uterine Fibroids

Objective To compare the change of PaCO2,blood preasure(BP),and blood oxygen(SPO2),between laparoscopic cholecystectomy and laparoscopic resection of the uterine fibroids.To explore the change of the PaCO2and hemodynamic in different laparoscopic operation.in order to adjust the tidal volume(VT) and frequency in time.and reduce bad influence during pneumoperitoneum and make prevention of complications caused by hypercapniaMethods All the cases are from Yanbian university hospital,devided into two groups,A and B with20patient in each those are under going laparoscopic cholecystectomy and laparoscopic resection of the uterine fibroids.aged from25-55,weight50-75kg,preoperative instructions to patients and their families to the contents of the experiment,informed consent was obtained.exclude with serious heart,liver,kidney disease. Serious anemia, anesthetic allegy, and recent respiratory tract infection.0.5mg Atropin intramuscalar inject30minut before the operation. Indution of nesthesia and intubation with Midazolom, Fentanyl, Cis-atracurium, Etomidate. During the operation maintained with propofol, remifenanil,isofoflurane. tidal volume(VT):8ml/kg;frequency:12times per minute.those are remain unchanged during the operation.place the catheter in radial artery befor. Artificial pneumoperitoneum10minute after intubation. Changed position when the abdominal pressure reached12-14mmHg.15-20°Trendelenburg position for gynecological surgery.patient underwent laparoscopic cholecystectoy(LC) take head-high foot low and at an angle of declination by15-20°to the left.monitor both group of blood gass analysis,blood pressure(BP),heart rate(HR) and blood oxygen(SPO2) before pneumoperitoneum,5,10,15,20min after pneumoperitoneum,5,10.15min after release from pneumoperitoneum.to observe the change of PaCO2,blood pressure(BP), heart rate(HR) and blood oxygen(SPO2).Result (1) compare the each time of before,after and release pneumoperitoneum BP and HR between two group:compare the two groups’each time point HR and BP,there were no significant difference.(P>0.05); compare in the group,each time point of after pneumoperitoneum(T1、T2、T3、T4)were higher than before pneumoperitoneum (T0),there were significant difference.(P<0.05), after release pneumoperitoneum,BP and HR were get close to before pneumoperitoneum. Compare T5、T6、T7with To there were no significant difference.(P>0.05);(2) compare the each time point of before,after and release pneumoperitoneum PaCO2between two group:compare the each time of before and after pneumoperitoneum PaCO2between two group,there were no significant difference.(P>0.05); release pneumoperitoneum, PaCO2in group B were higher than group A, there were significant difference.(P<0.05),(3) compare in the group, in group A,each time point of after and release pneumoperitoneum PaCO2are higher than before pneumoperitoneum, there were significant difference.(P<0.05), after release pneumoperitoneum T5、T6、T7PaCO2were lower than T4.In group B each time point of after and release pneumoperitoneum PaCO2are higher than before pneumoperitoneum, there were significant difference.(P<0.05), after release pneumoperitoneum T5、T6、T7PaCO2were higher than T4.both T1、T2、T3were higher than To. there were significant difference.(P<0.05).Conclusion1. compare laparoscopic cholecystectomy PaCO2with laparoscopic resection of the uterine fibroids,within20minute pneumoperitoneum,there are no significant difference.2. compare laparoscopic resection of the uterine fibroids after release pneumoperitoneum PaCO2is higher than laparoscopic cholecystectomy3. compare laparoscopic cholecystectomy Hemodynamic with laparoscopic resection of the uterine fibroids,there are no significant difference.