Effects Of Different Body Positions On Respiratory Dynamics And Blood Gas In Laparoscopic Surgery Of Gastrointestinal Surgery

Objective:To observe the effects of different body positions on respiratory dynamics and blood gas during laparoscopic surgery.Methods:80 patients undergoing laparoscopic surgery for gastrointestinal surgery in our hospital,ASA grade I-II,age 30-70 years old,The operation time is less than 3 hours.According to the type of surgery,80patients were randomly divided into two groups:group A,and group B,40patients in each group.The anesthesia machine was set to a respiratory rate of 12 beats/min before the establishment of the pneumoperitoneum for 20minutes,and the tidal volume was set to 8 ml/kg according to the ideal body weight.PaCO₂ was observed 20 minutes after artificial pneumoperitoneum.If the PaCO₂ level was≥45mmHg,the respiratory rate increased twice,that is,the minute ventilation（MV）increased by 10-20%.If the PaCO₂ level was still>45mmHg after the pneumoperitoneum establishment time,then The respiratory rate is increased twice more.If PaCO₂ is stable and there is no upward trend,the respiratory rate is no longer adjusted.Before tracheal intubation（T0）,post-tracheal position change（T1）,pneumoperitoneum20min（T2）,pneumoperitoneum 1h（T3）,pneumoperitoneum 1.5h（T4）,gas At the six time points of abdomen release（T5）,the respiratory rate（RR）,peak airway pressure（Ppeak）,airway platform pressure（Pplat）,oxygen partial pressure（PaO₂）,arterial blood gas carbon dioxide were observed and recorded in the two groups.Partial pressure（PaCO₂）,acid-base balance value（PH）and other values.Results:Compared with the pneumoperitoneum,the respiratory rate increased after the establishment of pneumoperitoneum（P<0.05）.The B group required a larger respiratory rate than the A group（P<0.05）.The airway peak pressure（Ppeak）and platform pressure（Pplat）of the two groups were increased after pneumoperitoneum（P<0.05）.The difference between the two groups was prolonged after artificial pneumoperitoneum.Peak airway pressure（Ppeak）and platform pressure（Pplat）showed a progressive increase trend,the difference was statistically significant（P<0.05）;airway peak pressure（Ppeak）and platform pressure（Pplat）after pneumoperitoneumThe value was significantly larger than that of group A,and the difference was statistically significant（P<0.05）.The values??of PaCO₂ at each time point were higher than those before pneumoperitoneum in the two groups（P<0.05）.There was no significant difference in PaCO₂between the two groups before the pneumoperitoneum（P>0.05）.The PaCO₂of group B was significantly higher than that of group A,and the difference was statistically significant（P<0.05）.The PH value of the two groups was lower than that before the establishment of pneumoperitoneum,and the difference was statistically significant（P<0.05）.The PH value of group B after pneumoperitoneum was lower than that of group A,the difference was statistically significant（P<0.05）.Conclusion:The position of gastrointestinal surgery has a significant effect on respiratory function and blood gas.The lower head position is more obvious than the supine position.The lower head position requires more ventilation than the supine position.The patient’s head low breathing parameter setting:RR=14 times/min,the tidal volume is set to 8ml/kg according to the ideal body weight,which can avoid the occurrence of hypercapnia to some extent,and has guiding significance for the respiratory parameter setting of patients with sub-type surgery.