Effect of pressure versus volume in controlled ventilation in overweight and obese patients during laparoscopic cholecystectomy

Abstract EN

Objectives: Proper ventilation techniques are debatable for laparoscopy procedures in high body mass index (BMI) participants.

We compared respiratory outcomes between pressure and volume ventilations in high (BMI) participants, assigned to laparoscopic cholecystectomy.

Methods: Our prospective and double blinded investigation involved 103 patients of both sexes, aged 34–58 years, BMI between 27 and 36 kg/m2 with ASA I–II assigned for laparoscopic cholecystectomy at Prince Hashem Hospital, Zarqa and Queen Alia Hospital, Amman, Jordan, between (June 2018- July 2019).

General anaesthesia was initiated using volume ventilation, but after 10 min of pneumoperitoneum with 8–10 mmHg intra-abdominal pressure, patients were randomly divided.

Group I patients (n=51) received pressure controlled ventilation and group II patients (n=52) received volume controlled ventilation.

Ventilation was manipulated to achieve an end tidal CO2 between 30 and 35 mmHg.

Mean and peak airway pressure data were collected.

Results: Patients in group II required more (TV) and respiratory rates to attain an ETCOR2R of 30–35 mmHg, at 25–60 min after pneumoperitoneum.

There were no significant discrepancies between both groups regarding mean airway pressures, but peak airway pressures at 25–60 min after pneumoperitoneum were higher in group II than group I.

Conclusions: Although some positive effects were observed in terms of mean airway pressures using pressure ventilation, there were no significant discrepancies between pressure and volume ventilations in high body mass index patients, scheduled for laparoscopic cholecystectomy.-