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Minimal impairment in pulmonary function following laparoscopic surgery
Author(s) -
STAEHRRYE A. K.,
RASMUSSEN L. S.,
ROSENBERG J.,
STEENHANSEN C.,
NIELSEN T. F.,
ROSENSTOCK C. V.,
CLAUSEN H. V.,
SØRENSEN M. K.,
H. REGEUR J.,
GÄTKE M. R.
Publication year - 2014
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/aas.12254
Subject(s) - medicine , pulmonary function testing , surgery , cholecystectomy , anesthesia , hysterectomy , confidence interval , laparoscopy , pulmonary shunt , hemodynamics
Background Pulmonary function may be impaired in connection with laparoscopic surgery, especially in the head‐down body position, but the clinical importance has not been assessed in detail. The aim of this study was to assess pulmonary function after laparoscopic hysterectomy and laparoscopic cholecystectomy. We hypothesised that arterial oxygenation would be more impaired after hysterectomy performed in the head‐down position than after cholecystectomy in the head‐up position. Methods We included 60 women in this prospective, observational study. The patients underwent elective laparoscopic cholecystectomy in the 20° head‐up position or hysterectomy in the 30° head‐down position. The primary outcome was the difference between arterial oxygenation ( PaO 2 ) 2 h postoperatively and the preoperative value. Two hours and 24 h after surgery, pulmonary shunt and ventilation–perfusion mismatch were assessed by use of an automatic lung parameter estimation system. Results Two hours after surgery, the mean change from baseline in PaO 2 was −0.65 kPa [95% confidence interval ( CI ) −3.5 to 3.4, P = 0.14] in the hysterectomy group and −0.22 kPa [95% CI −3.4 to 2.0, P = 0.12] in the cholecystectomy group ( P = 0.88). Shunt was significantly greater in the cholecystectomy group 24 h after surgery compared to the hysterectomy group [4%, 95% CI 0 to 9 vs. 0%, 95% CI 0 to 7, P = 0.02]. Conclusions Minimal impairment in pulmonary gas exchange was found after laparoscopic surgery. Pulmonary shunt was larger after laparoscopic cholecystectomy, but no clinically significant differences in postoperative pulmonary gas exchange or spirometry were found between laparoscopic hysterectomy and laparoscopic cholecystectomy.