Effects Of Different Trendelenburg Position On Pneumodynamics During Gynecological Laparoscopic Operations

Objective To observe the effects of different Trendelenburg position on pneumodynamics during gynecological laparoscopic operations.Methods 60 cases undergoing gynecological laparoscopic operations,ASAⅠ～Ⅱgrade,were divided into two groups:30 cases of Trendelenburg position were kept 30 degree (group T₁) and the rest were 45 degree(group T₂).To monitor and record tidal volume(VT),minute ventilation(MV),Ppeak,Pplat,lung compliance(CL),ent-tidal CO₂(P_ETCO₂), Shortly after intubation(t₁),15min after mechanical ventilation(t₂);shortly(t₃),30min(t₄),60min(t₅) after Trendelenburg position.Results Two groups patients VT,MV decreased significantly after Trendelenburg position and pneumoperitoneum(P＜0.01),which of group T₂ were more significantly (P＜0.05).Ppeak,Pplat of two groups both increased higher and higher as time passed (P＜0.01).Group T₂ increased more significantly than group T₁ after Trendelenburg position and pneumoperitoneum(P＜0.01).CL of two groups decreased significantly after Trendelenburg position and pneumoperitoneum(P＜0.01).CL of two groups remained unchanged t₄ and t₅(P＞0.05),which of group T₂ were more significantly(P＜0.01).P_ETCO₂ of two groups increased siginificantly after Trendelenburg position and pneumoperitoneum.In addition,it became higher and higher as time passed after Trendelenburg position and pneumoperitoneum(P＜0.01).Group T₂ increased more significantly than group T₁ after Trendelenburg position and pneumoperitoneum(P＜0.01).Conclusion Trendelenburg position affects pneumodynamics during gynecological laparoscopic operations.The effect of 45 degree Trendelenburg position is significantly higher than 30 degree Trendelenburg position.