Significance Of End-Tidal Carbon Dioxide Partial Pressure In Recovery After Laparoscopic Cholecystectomy Under General Anesthesia In The Elderly Patients

Objective:To evaluate the application of end-tidal carbon dioxide partial pressure(PetCO2)monitoring in the recovery from laparoscopic cholecystectomy under general anesthesia,and to provide reference for the safety of recovery from anesthesiaMethods:Sixty-two patients aged 50-80 years,weighing 51-87.5 kg and ASA grade Ⅰ-Ⅱ were selected for laparoscopic cholecystectomy under general anesthesia.They were divided into two groups,group A,27cases,aged less than 65 years,and group B,35cases,aged more than or equal to 65 years.Intraoperative anesthesia was maintained with propofol and sevoflurane,and tracheal tube was removed after operation.PetCO2 and PaCO2 were monitored immediately after entering the resuscitation room(T1),10 min(T2),20 min(T3),30 min(T4).The correlation between PetCO2 and PaCO2 was analyzed,then PetCO2,PaCO2,PaCO2-PetCO2,the incidence of abnormal PetCO2,the hemodynamic changes and Steward score,each time point between two groups were compared,and that were also compared within groups.Results:1.There was a positive correlation between PetCO2 and PaCO2 in group A and group B.(P<0.01).2.There was no significant difference between groups A and B in PetCO2,PaCO2 at all time point(P>0.05),PaCO2 was higher than PetCO2 at all time point in group A and B(P<0.05).PetCO2 and PaCO2 in group A and B decreased gradually from TI to T4and the difference of that between each time point was significant(P<0.05).3.There was no significant difference in PaCO2-PetCO2 difference between groups A and B at all time points(P>0.05),there was no significant difference between groups at all time points(P>0.05).4.There was no significant difference in hemodynamic changes between groups A and B at T1-T4(P>0.05).5.The abnormal rate of PetCO2 in group A was 51.85%at T1,44.44%at T2.33.33%at T3 and 25.93%at T4,77.14%at TI,71.43%at T2,60%at T3 and 57.14%at T4.The abnormal rate at T4 in group A was significantly lower than that at T1(P<0.05).The abnormal rate of group B was significantly higher than that of group At all time points.At T1(χ2=4.353,P=0.037),at T2(χ2=4.612,P=0.032),at T3(X2=4.34,P=0.038),and at T4(χ2=6.042,P=0.014).6.There was no significant difference in Steward score between groups A and B at T1-T4(P>0.05).Conclusion:PetCO2 monitoring during anesthesia recovery in elderly patients after laparoscopic cholecystectomy can detect CO2 accumulations in time,so as to improve the quality and safety of anesthesia recovery.