| Objective:To study the effect of methylprednisolone on respiratory dynamics during laparoscopic uterus and accessory resection in elderly patients.Methods:In this prospective,randomized controlled double-blind study,sixty patient?aged60-70years,BMI 18-24,ASA gradeI-II?scheduled for Laparoscopic uterus plus bilateral accessory resection were randomly divided into two groups?n=30,each group?using a random number table:the control group?groupC?and the methylprednisolone group?groupM?.In the induction of general anesthesia,group M was given methylprednisolone 1 mg/kg by intravenous injection,and group C was given normal volume of normal saline.Mechanical ventilation parameters:inhaled oxygen concentration:60%,tidal volume:6ml/Kg,ventilation frequency:12 times/min,inspiratory-to-expiratory?I:E?ratio:1:2.Respiratory dynamics indicators:peak airway pressure?Ppeak?,airway platform pressure?Pplat?,lung compliance?Compl?were recorded at the 5min before pneumoperitoneum?T0?,15min after pneumoperitoneum?T1?,30min after pneumoperitoneum?T2?,45min after pneumoperitoneum?T3?,10minutes after deflation?T4?.The arterial blood gas analysis were performed at T0,T3 in order to determined the oxygen partial pressure?PaO2?,carbondioxide partial pressure?PaCO2?,oxygenation index?OI?and blood glucose value?Glu?.Results:Compared with T0,Ppeak and Pplat were significantly increased in T1,T2 and T3whereas Compl was significantly decreased in both group?P<0.05?.Compared with group C,Ppeak and Pplat in group M were significantly lower in T2 and T3,and Compl was significantly increased.PaO2 and OI were significantly increased?P<0.05?,PaCO2was significantly lower at T3?P<0.05?;there was no significant difference in Glu at T3.Conclusion:Methylprednisolone can increase lung compliance during laparoscopic surgery in elderly patients,optimize intraoperative respiratory mechanics,increase oxygenation,reduce the adverse effects of respiratory degenerative diseases and pneumoperitoneum on patients. |
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