Can Pulse Oximetry and End-Tidal Capnography Reflect Arterial Oxygenation and Carbon Dioxide Elimination During Laparoscopic Cholecystectomy?

Baraka, Anis; Jabbour, Samar; Hammoud, Rola; Aouad, Marie T.; Najjar, Faysal; Khoury, Ghattas; Sibai, Abdel Nour

doi:10.1097/00019509-199410000-00006

Cited by 13 publications

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“…In our series, monitoring arterial PCO 2 was essential, since in most cases there was a great individual difference between the two values (from 10% to 40%). This result was in agreement with many earlier reports; the normal gradient of 0.4-0.67 kPa between PaCO 2 and EtCO 2 was markedly increased in ASA III-IV patients, in those with a high ventilation/perfusion rate, as well as during hyperventilation, decreased cardiac output, or hypovolemia [1,3,25].…”

Section: Discussionsupporting

confidence: 93%

“…A thorough understanding of these changes is imperative. It is also necessary both to determine the minimum preoperative risk factors and to design a system for monitoring and maintaining a satisfactory intraoperative course for all patients [1,14,24,25]. CO 2 insufflation and rT position are the main problems, followed by abdominal distention, potential hypercarbia, and acidosis [2,3,23,25].…”

Section: Discussionmentioning

confidence: 99%

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Hemodynamic and pulmonary changes during and after laparoscopic cholecystectomy A comparison with traditional surgery

et al. 1998

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Hemodynamic and pulmonary changes during and after laparoscopic cholecystectomy A comparison with traditional surgery

et al. 1998

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“…8 Correlation of this maximum PETCO 2 tension with the corresponding baseline values prior to CO 2 insufflation showed a positive linear relationship (Correlation coefficient 0.86). The correlation showed that PETCO 2 tension of 5.32 Kpa (40 mmHg) could be achieved during laparoscopy when baseline values is adjusted to around 4.0 Kpa (30 mmHg).…”

Section: Discussionmentioning

confidence: 85%

End tidal CO2 level (PETCO2) during laparoscopic surgery: comparison between spinal anaesthesia and general anaesthesia

Jadhav

Puram

Ramanand

et al. 2017

Int J Basic Clin Pharmacol

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Background: Laparoscopy is a procedure which involves insufflations of the abdomen by a gas, so that endoscope can visualise intra abdominal content without being in direct contact with viscera or tissues. Its advantages are small incisions, less pain, less postoperative ileus, short hospital stay compared to traditional open method. Monitoring of end tidal carbon dioxide (PETCO2) and hemodynamics is very necessary during Laparoscopy surgery. This study is conducted to find out effects of CO2 insufflation on parameters like PETCO2, Mean arterial pulse pressure, SPO2 under spinal anaesthesia and general anaesthesia in ASA I and ASA II patients.Methods: The present study was conducted in the department of anaesthesiology from December 2014 to September 2015.This study was a prospective, randomized controlled, single blind. Each group consisted of 30 patients having Group A and Group B as patient undergoing laparoscopic surgery under Spinal anaesthesia and General anaesthesia respectively. Preoperatively patients in Group A (Spinal anaesthesia) given inj. Midazolam 0.3mg/kg IM 45 before surgery and Group B (General anaesthesia) inj. pentazocin 0.3mg/kg, inj. promethazine 0.5mg/kg, inj. Glycopyrrolate 0.004 mg/kg IM 45 before surgery. In operation theatre, intra operative pulseoximetre, ECG, SPO2, Heart rate (HR), Mean arterial pulse pressure and PETCO2 monitoring done. Amount of CO2 insufflated noted.Results: It was found from present study that in both group there was significant progressive rise in PETCO2 after CO2 insufflation, with peak at 30 min and thereafter plateau till the end of procedure (avg. duration 45-60 min). In group A i.e. laparoscopic surgery under spinal anaesthesia with (spontaneous respiration) the rise in PETCO2 was significant as compared to the group B i.e. laparoscopic surgery under general anaesthesia with controlled ventilation. The heart rate increased after CO2 insufflation in both the group, but it was significant in group A. The increase in SBP, DBP, MAP were less in group A as compared to group B. SPO2 showed no significant changes and it remained above 97% in all patients throughout surgery. All values come to baseline 15 min after insufflation.Conclusions: From the present study it can be concluded that balanced general anaesthesia using IPPV with moderate hyperventilation, as the preferred anaesthetic technique for laparoscopic surgery.

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“…1994 reports that in ASA class 1 or 2 patients during laparoscopy, no significant change in the PaCO 2 -etCO 2 gradient after carbon dioxide insufflation. They conclude that end-tidal capnography can be used as noninvasive techniques for monitoring arterial carbon dioxide elimination during laparoscopic surgery in healthy patients [3]. The end-tidal PCO 2 increases hand-in-hand with the arterial PCO 2 during laparoscopic surgery [4].…”

Section: Discussionmentioning

confidence: 99%

Unexpected Increase in Arterial to End-Tidal CO<sub>2</sub> Gradient in a Child Undergoing Embolization of MAPCAs

Mahmoud¹,

Sedeek²,

McQuillan³

2017

OJAnes

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A 17-month-old infant with multiple aorto-pulmonary collateral arteries (MAPCAs) and pulmonary hypertension presented for diagnostic catheterization. On the day of the procedure, the infant was asymptomatic with oxygen saturation in the 90's on 1.0 L/min O 2 nasal cannula. His parents denied any recent illness. During the procedure, one coil was inadvertently embolized into the right lung resulting in markedly increased pulmonary artery pressures.The Pa-etCO 2 gradient increased to 25 mmHg from a baseline of 2 mmHg.Therapy was initiated to reduce the PaCO 2 . The patient could not be weaned from mechanical ventilation due to elevated PA pressures.

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Can Pulse Oximetry and End-Tidal Capnography Reflect Arterial Oxygenation and Carbon Dioxide Elimination During Laparoscopic Cholecystectomy?

Cited by 13 publications

References 0 publications

Hemodynamic and pulmonary changes during and after laparoscopic cholecystectomy A comparison with traditional surgery

Hemodynamic and pulmonary changes during and after laparoscopic cholecystectomy A comparison with traditional surgery

End tidal CO2 level (PETCO2) during laparoscopic surgery: comparison between spinal anaesthesia and general anaesthesia

Unexpected Increase in Arterial to End-Tidal CO<sub>2</sub> Gradient in a Child Undergoing Embolization of MAPCAs

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Can Pulse Oximetry and End-Tidal Capnography Reflect Arterial Oxygenation and Carbon Dioxide Elimination During Laparoscopic Cholecystectomy?

Cited by 13 publications

References 0 publications

Hemodynamic and pulmonary changes during and after laparoscopic cholecystectomy A comparison with traditional surgery

Hemodynamic and pulmonary changes during and after laparoscopic cholecystectomy A comparison with traditional surgery

End tidal CO2 level (PETCO2) during laparoscopic surgery: comparison between spinal anaesthesia and general anaesthesia

Unexpected Increase in Arterial to End-Tidal CO&lt;sub&gt;2&lt;/sub&gt; Gradient in a Child Undergoing Embolization of MAPCAs

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Unexpected Increase in Arterial to End-Tidal CO<sub>2</sub> Gradient in a Child Undergoing Embolization of MAPCAs