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Gallstones are one of the most common diseases of the gastrointestinal tract. Most of these stones remain asymptomatic throughout the patient’s life. For unknown reasons, some patients progress to a symptomatic stage that develops biliary colic following cystic duct obstruction by gallstones. This may lead to complications including cholecystitis, chronic cholecystitis, cholangitis, pancreatitis, fistula between the gallbladder and part of the intestine, and eventually ileus caused by gallstones and gallbladder carcinoma.1, 2 Therefore, if bile stones develop or are symptomatic or in conditions that are more likely to cause these complications, cholecystectomy is required. This can be done in an open procedure or in a so-called laparoscopic procedure.3 The use of this method has been growing increasingly so that it has been replaced by the open method of choice4 due to it its many benefits and fewer side effects such as reduced post-operative pain, faster return to work, reduced hormonal neurotoxicity, patients’ satisfaction with the appearance of the scar and the less invasive nature of laparoscopic surgery than open surgery. The use of this method has been growing increasingly so that it has been replaced as an alternative choice method. In this way, it is necessary to dilate the space inside the abdomen to create the proper space for working with the necessary devices and tools. Therefore, various gases such as nitrogen, helium and CO2 are used for dilution, each with its advantages and disadvantages. The most common gas used in laparoscopy is CO2 because it is non-combustible, absorbs rapidly in dissolved blood and is excreted through the respiratory tract.5, 6 Arterial carbon dioxide (PaCO2) pressure is one of the most important determinants of blood pH, so its changes can cause many disorders for patients. Since the probability of this change was high during anesthesia and it’s not possible to monitor PaCO2 directly, during anesthesia, ET-CO2 expiratory CO2 pressure monitoring is used to estimate PaCO2. It is nowadays one of the standard monitoring methods during anesthesia and is often used as a non-invasive procedure for patients during anesthesia as well as in recovery and intensive care units.7 According to the ASTM International (formerly known as American Society for Testing and Materials), the measurement of CO2 pressure is now mandatory monitoring and capnography is a standard anesthesia monitoring.8, 9 Continuous measurement of exhaled CO2 is one of the methods that are used in the operating room for evaluation during anesthesia and in patients intubated in the tracheal intubation. But this approach can even be a non-invasive, rapid, and reliable method for predicting PaCO2 in non-intubated patients. 10 This measurement enables the estimation of PaCO2 pressure without the need for arterial blood sampling. If there is a consistent relationship between the CO2 pressure and the arterial end, this method is reliable and there will be no need for repeated arterial blood sampling.11, 12 So, the aim of this paper is to determining the end-expiratory dioxide pressure in gallbladder laparoscopic surgery and compares it with the PaCO2 pressure.

journal of contemporary medical sciences

Investigating the partial pressure of carbon dioxide (CO2) in the respiratory gases in Laparoscopic Gallbladder Surgery and comparing it with Arterial Partial Pressure of Carbon Dioxide