Surgical Research Society
Ventilatory and blood gas changes during laparoscopic and open cholecystectomy
Article first published online: 6 DEC 2005
Copyright © 1993 British Journal of Surgery Society Ltd.
British Journal of Surgery
Volume 80, Issue 10, pages 1252–1254, October 1993
How to Cite
McMahon, A. J., Baxter, J. N., Kenny, G. and O'Dwyer, P. J. (1993), Ventilatory and blood gas changes during laparoscopic and open cholecystectomy. Br J Surg, 80: 1252–1254. doi: 10.1002/bjs.1800801010
- Issue published online: 6 DEC 2005
- Article first published online: 6 DEC 2005
- Manuscript Accepted: 6 JUL 1993
As part of a randomized trial, ventilatory and arterial blood gas changes were assessed during open (n = 30) and laparoscopic (n = 30) cholecystectomy. Measurements were made during anaesthesia before the start of surgery and at the time of removal of the gallbladder. Despite an increase in minute ventilation from a mean(s.d.) of 5·7(1·4) to 6·1(1·2) litres, mean(s.d.) arterial carbon dioxide tension (PaCO2) rose from 5·3(0·9) to 6·0(0·9) kPa during laparoscopic cholecystectomy. End-tidal carbon dioxide tension (PE'CO2) had poor precision in predicting PaCO2 (95 per cent interval of agreement −0·61 to 1·93 kPa). Mean(s.d.) peak airway pressure increased from 17(4) to 23(4) cmH2O. The mean PaCO2–PE'CO2 value did not change significantly, although there was significant within-patient variation. Arterial oxygen levels did not change significantly. By comparison, no clinically significant changes in ventilation or blood gas values occurred during open cholecystectomy. In conclusion, laparoscopic cholecystectomy requires a substantial but variable increase in minute ventilation to compensate for carbon dioxide absorption from the peritoneum.