Comparison of volume-controlled and pressure-controlled ventilation in the Trendelenburg position for gynecological laparoscopic surgery

Abstract

Background: Minimal invasive gynecologic surgery usually requires pneumoperitoneum and Trendelenburg positioning, which results in adverse effects on respiratory and hemodynamic parameters. The aim of this study was to investigate the effects of volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV) introduced sequentially in patients who underwent gynecological laparoscopy on respiratory mechanics, cardiovascular responses, and gas exchange. Methods: Forty patients who were scheduled for gynecologic laparoscopic surgery were enrolled. Baseline ventilation of their lungs was performed with VCV with a tidal volume (TV) of 8 ml/kg ideal body weight (IBW). Forty minutes after pneumoperitoneum and Trendelenburg positioning, the ventilation mode was changed to PCV, and airway pressure was set to provide a TV of 8 ml/kg IBW without exceeding 35 cmH2O. Respiratory mechanics and hemodynamic and gas exchange parameters were recorded at 10

Noch zeitgemäß? – Bauchbinden nach Laparotomie

“…Die Forschenden empfehlen die Intervention daher nicht. In beiden Gruppen lag das Schmerzlevel zwischen 3 und 4/10 auf der NRS, gemessen 12, 24 und 36 Stunden nach der Operation 14 .…”