The Effect of Low-Flow Sevoflurane and Desflurane on Pulmonary Mechanics During Laparoscopic Surgery

Sivaci, Remziye; Orman, Ayşe; Yılmazer, Mehmet; Yılmaz, Sezgin; Ellıdokuz, Hülya; Polat, Coşkun

doi:10.1089/lap.2005.15.125

Cited by 13 publications

(12 citation statements)

References 26 publications

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“…However, the changes in total resistance and compliance reflect Raw and C [6,19] and the effects of the chest wall and lung tissue would be little or unchanged, equally in all patients; therefore, this is unlikely to change our results. The advantage of using this technique is that data are displayed continuously; furthermore, these values have been shown to be accurate in previous studies [5-7,11,16]. Oikkonen and Tallgren [16] reported that Cdyn decreased immediately after insufflation and was not influenced by duration of pressurization, so the timing of our measurements of respiratory parameters was appropriate.…”

Section: Discussionmentioning

confidence: 92%

“…This leads to an increase in PIP and Raw as well as a decrease in functional residual capacity and pulmonary compliance [5,16,20-23]. Oikkonen and Tallgren [16] reported that there was no association between age, sex, BMI, duration of pressurization, or changes in Cdyn during laparoscopic surgery.…”

Section: Discussionmentioning

confidence: 99%

“…However, other studies have reported that several factors (patient's position, BMI, anesthetic agents etc.) affect the extent of respiratory mechanics changes during laparoscopic surgery [5,16,20,22,23]. These changes could be aggravated in patients with pre-existing pulmonary diseases, or morbid obesity [21,22], which is why we excluded these patients.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of respiratory mechanics between sevoflurane and propofol-remifentanil anesthesia for laparoscopic colectomy

Bang

Lee

Ahn

et al. 2014

Korean J Anesthesiol

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BackgroundThe creation of pneumoperitoneum and Trendelenburg positioning during laparoscopic surgery are associated with respiratory changes. We aimed to compare respiratory mechanics while using intravenous propofol and remifentanil vs. sevoflurane during laparoscopic colectomy.MethodsSixty patients undergoing laparoscopic colectomy were randomly allocated to one of the two groups: group PR (propofol-remifentanil group; n = 30), and group S (sevoflurane group; n = 30). Peak inspiratory pressure (PIP), dynamic lung compliance (Cdyn), and respiratory resistance (Rrs) values at five different time points: 5 minutes after induction of anesthesia (supine position, T1), 3 minutes after pneumoperitoneum (lithotomy position, T2), 3 minutes after pneumoperitoneum while in the lithotomy-Trendelenburg position (T3), 30 minutes after pneumoperitoneum (T4), and 3 minutes after deflation of pneumoperitoneum (T5).ResultsIn both groups, there were significant increases in PIP and Rrs while Cdyn decreased at times T2, T3, and T4 compared to T1 (P < 0.001). The Rrs of group PR for T2, T3, and T4 were significantly higher than those measured in group S for the corresponding time points (P < 0.05).ConclusionsRespiratory mechanics can be adversely affected during laparoscopic colectomy. Respiratory resistance was significantly higher during propofol-remifentanil anesthesia than sevoflurane anesthesia.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Comparison of respiratory mechanics between sevoflurane and propofol-remifentanil anesthesia for laparoscopic colectomy

Bang

Lee

Ahn

et al. 2014

Korean J Anesthesiol

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“…Especially in low flow anesthesia reactive oxygen species (ROS) are reduced due to the consumption of minimal sevoflurane and desflurane (19). Therefore, in low-flow anesthesia and lapa roscopic surgery morbidity and mortality are reduced (1,20).…”

Section: Discussionmentioning

confidence: 99%

“…A wide range of intraabdominal surgical procedures are increasingly being performed laparoscopically (1). In laparoscopic surgery patients, fresh gas flow rates and the kind of anesthetic agents used are important from the point of view that they have different effects on the organ systems.…”

Section: Introductionmentioning

confidence: 99%

Biochemical Effects of Low-Flow Anesthesia with Inhalation agents in Patients undergoing Laparoscopic Surgery

Sivaci¹,

Demir²,

Köken³

et al. 2012

Journal of Medical Biochemistry

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Summary: This study was designed to investigate the effects of low-flow anesthesia with sevoflurane and desflurane on renal and hepatic functions in patients undergoing laparoscopic abdominal surgery. Twenty patients with ASA I or II (American Society of Anesthesiologists classification) physi cal scores were included in the study. There were no signifi cant differences between sevoflurane and desflurane groups with respect to age, weight, body mass index, duration of the operation and the anesthesia. In both groups, renal function parameters such as urea, BUN, creatinine and calculated creatinine clearance did not show significant differences at 24 and 48 hours. Homocysteine levels, which showed renal metabolic function, did not change significantly at 24 and 48 hours when compared to baseline le vels in both groups. Transaminases were not significantly different between the two groups from baseline to 24 and 48 hours. These differences between the preoperative and post operative values of biochemical parameters were similar for both anes thetic groups (p>0.05). Low-flow anesthesia did not cause impairment in terms of renal and hepatic functions.

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Comparison of the Level of Free Hexafluoro-isopropanol in Adults’ Blood and the Incidence of Emergence Agitation After Anesthesia With Different Concentrations of Sevoflurane in Laparoscopic Gastrointestinal Surgery: A Randomized Controlled Clinical Trial

Feng

Chen

Yuan

et al. 2019

Clinical Therapeutics

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Purpose: The aim of the study is to compare the free hexafluoro-isopropanol (HFIP) concentration in adults' blood and the incidence of emergence agitation (EA) after inhaled different concentrations of sevoflurane. Methods: Sixty adult patients planning to undergo laparoscopic gastrointestinal surgery were randomly assigned to 3 groups. Each group received sevoflurane as the volatile anesthetic at different concentrations: 0.5 minimum alveolar concentration (MAC), 1.0 MAC, and 1.5 MAC. The use of sevoflurane was continued until the end of surgery. Venous blood samples were obtained at 30, 60, 120, and 180 minutes after starting the use of sevoflurane and subsequently at 60, 180, and 300 minutes after discontinuation of volatile anesthetic administration. Blood concentrations of sevoflurane and free HFIP were determined using gas chromatography. The recovery time and the incidence of EA at different time points were evaluated among the 3 groups. Findings: Changes in the blood concentrations of sevoflurane and free HFIP during and after the use of sevoflurane were similar in all 3 groups. The peak blood concentration of free HFIP occurred 60 minutes after onset of sevoflurane anesthesia in all 3 groups (P < 0.05). The lowest level of free HFIP and the longest recovery time were found in the 1.5-MAC group (P < 0.05). No significant difference was found in the incidence of EA or moderate pain among the 3 groups during recovery. Implications: The generation of HFIP would be inhibited when the inhaled sevoflurane concentration increased to 1.5 MAC. However, the incidence of EA during recovery had nothing to do with the inhaled different sevoflurane concentrations (within 1.5

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The Effect of Low-Flow Sevoflurane and Desflurane on Pulmonary Mechanics During Laparoscopic Surgery

Abstract: We concluded that respiratory mechanics were affected by desflurane with low flow anesthesia in patients undergoing laparoscopic abdominal surgery. No significant influence on respiratory mechanics was seen with sevoflurane anesthesia.

Cited by 13 publications

References 26 publications

Comparison of respiratory mechanics between sevoflurane and propofol-remifentanil anesthesia for laparoscopic colectomy

Comparison of respiratory mechanics between sevoflurane and propofol-remifentanil anesthesia for laparoscopic colectomy

Biochemical Effects of Low-Flow Anesthesia with Inhalation agents in Patients undergoing Laparoscopic Surgery

Comparison of the Level of Free Hexafluoro-isopropanol in Adults’ Blood and the Incidence of Emergence Agitation After Anesthesia With Different Concentrations of Sevoflurane in Laparoscopic Gastrointestinal Surgery: A Randomized Controlled Clinical Trial

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