Effect Of Repeated Alveolar Reemitment On Lung Gas Content In Patients Undergoing Laparoscopy-assisted Radical Colorectectomy

Objective:The purpose of this study was to investigate the effect of pulmonary alveolar recruitment at different intervals on lung volume in patients undergoing Laparoscopy-assisted Radical Colorectectomy using pulmonary ultrasound.Methods:Eighty-four patients who underwent elective Laparoscopy-assisted Radical Colorectectomy in the second affiliated hospital of soochow university were randomly divided into three groups according to different post-pneumoperitoneum time intervals for alveolar recruitment,28 patients in each group were randomly divided into three groups.Alveolar recruitment was performed every 30 minutes for the RM30 group,and alveolar recruitment was performed every 60 minutes for RM60 group and non-alveolar recruitment was performed for the control group C.Patients in each group were examined by pulmonary ultrasound at 20min before endotracheal intubation(T1 time point),20min after endotracheal extubation(T2 time point),and 24 hours after the operation(T3 time point),respectively.and the video of the corresponding area was recorded for later ultrasound scoring.At 5min after intubation(G1 time point)and 5min after pneumoperitoneum(G2 time point),arterial blood gas examination was performed once,and PH value,PaCO2 and oxygenation index(PO2/FiO2)of the patients were recorded.Results:1,Compared with T1 time point,the total of LUS scores at T2 and T3 time points increased in all the three groups,with the control group having the highest score at T2 time point and the region with the higher score in the back.2,At T2 time point:the total score of RM30 group was lower than RM60 group,RM60 group was lower than C group,and in the upper back(the sum of the upper of left and right back LUS),the LUS score of RM30 group and RM60 group were lower than C group,RM30 group and RM60 group were lower than RM60 group in the lower back(the sum of the lower of left and right back),RM60 group were lower than the C group,all the difference was statistically significant(P<0.05).3,The total LUS score at T3 time point difference of the three groups was not statistically significant(P>0.05),but the total LUS score at T3 time point of RM30 group increased compared with T2 time point,while the total LUS score at T3 time point of the C group decreased compared with T2 time point,the difference was statistically significant(P<0.05).4,The arterial blood gas oxygenation index of RM30 group and RM60 group at G2 time point was higher than G1 time point,and the difference was statistically significant(P<0.05).conclusion1,Patients undergoing laparoscopic colorectal cancer surgery experienced a decrease in lung gas content of different degrees after general anesthesia,which was severe in the back,and severe after extubation,and last for more than one day after surgery.2,Alveolar recruitment can improve arterial oxygenation,improve pulmonary ventilation and reduce atelectasis in patients.3,Intraoperative alveolar recruitment every 30 minutes was better than that every 60 minutes to improve the reduction of pulmonary gas content 20 minutes after extubation,but the difference was not significant for 24 hours after surgery.