Comparison of effects of volume-controlled and pressure-controlled mode of ventilation on endotracheal cuff pressure and respiratory mechanics in laparoscopic cholecystectomies: A randomised controlled trial

Background and Aims: During laparoscopic surgeries, pneumoperitoneum increases intraabdominal pressure (IAP) which can increase the central venous pressure (CVP), and significant haemodynamic changes. In this study, we evaluated the effect of two different pressures of pneumoperitoneum, standard (13-15 mmHg), and low (6-8 mmHg) on the cross-sectional area (CSA) of the internal jugular vein (IJV) using ultrasonography, haemodynamic changes and duration of surgery. Surgeon’s comfort and feasibility of performing laparoscopic surgeries with low pressure pneumoperitoneum was also studied. Methods: This prospective, double-blind, randomised study included 148 patients of American Society of Anesthesiologists physical status class I and II undergoing laparoscopic surgeries. They were allocated into two groups: group S (standard) (number (n) = 73) had the IAP maintained between 13-15 mmHg; group L (low) had an IAP of 6-8 mmHg (n = 75). CSA of right IJV was measured before induction of anaesthesia (T1), 5 min after intubation (T2), 5 min after pneumoperitoneum (T3), before desufflation (T4) and 5 min prior to extubation (T5). Chi-square test, and Student’s paired and unpaired t test were used for statistical analysis. Results: The increase in IJV CSA at T3 when compared to T2 was statistically significant in both the groups (P < 0.001). On desufflation, the change in IJV CSA showed significant decrease in T5 value than T4 value in both the groups (P < 0.001). However, the percentage change in the IJV CSA was more in group S (35.4%) than group L (21.2%). Conclusion: CSA of IJV increased significantly even with lower IAP of 6-8 mmHg. Laparoscopic surgery can be performed conveniently even at low IAP.

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Battle of the Gases: How Air and Nitrous Oxide Affect Endotracheal Tube Cuff Pressure During General Anesthesia

Bagle,

Raj,

Gaur

et al. 2024

Cureus

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Comparison of effects of volume-controlled and pressure-controlled mode of ventilation on endotracheal cuff pressure and respiratory mechanics in laparoscopic cholecystectomies: A randomised controlled trial

Cited by 3 publications

References 14 publications

Workstation peril: Paradoxical inability to ventilate in manual/spontaneous mode with mechanical ventilation modes unaffected

Workstation peril: Paradoxical inability to ventilate in manual/spontaneous mode with mechanical ventilation modes unaffected

The effect of different pressures of pneumoperitoneum on the dimensions of internal jugular vein – A prospective double-blind, randomised study

Battle of the Gases: How Air and Nitrous Oxide Affect Endotracheal Tube Cuff Pressure During General Anesthesia

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