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Effects of high positive end‐expiratory pressure on haemodynamics and cerebral oxygenation during pneumoperitoneum in the Trendelenburg position
Author(s) -
Jo Y. Y.,
Lee J. Y.,
Lee M. G.,
Kwak H. J.
Publication year - 2013
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/anae.12284
Subject(s) - medicine , pneumoperitoneum , anesthesia , trendelenburg position , cerebral perfusion pressure , positive end expiratory pressure , hemodynamics , trendelenburg , oxygenation , peak inspiratory pressure , mean arterial pressure , blood pressure , respiratory system , surgery , cerebral blood flow , tidal volume , heart rate , mechanical ventilation , laparoscopy
Summary We investigated the effects of 10 cmH 2 O positive end‐expiratory pressure on cerebral haemodynamics and cerebral oxygenation in patients undergoing laparoscopic lower abdominal surgery in the 30° Trendelenburg position during desflurane anaesthesia. Twenty‐six patients were enrolled in this study. After anaesthesia induction, pneumoperitoneum was applied in Trendelenburg position. Twenty minutes later, positive end‐expiratory pressure was applied. There was no change in regional cerebral oxygen saturation (p = 0.376). Cerebral perfusion pressure decreased significantly over time (p < 0.001) and positive end‐expiratory pressure caused a further decrease in cerebral perfusion pressure (p = 0.036). The application of 10 cmH 2 O positive end‐expiratory pressure during pneumoperitoneum in the Trendelenburg position preserved regional cerebral oxygen saturation, but cerebral perfusion pressure decreased significantly due to its secondary haemodynamic effects.