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Are pulse oximetry and end‐tidal carbon dioxide tension monitoring reliable during laparoscopic surgery?
Author(s) -
NYARWAYA J.B.,
MAZOIT J.X.,
SAMII K.
Publication year - 1994
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/j.1365-2044.1994.tb04449.x
Subject(s) - medicine , anesthesia , partial pressure , carbon dioxide , pneumoperitoneum , pulse oximetry , mean arterial pressure , blood pressure , surgery , oxygen , heart rate , laparoscopy , chemistry , organic chemistry
Summary Cardiorespiratory changes induced by pneumoperitoneum and head‐up tilt may generate alveolar ventilation to perfusion ratio changes and increased systemic vascular resistances. The reliability of end‐tidal carbon dioxide tension and pulse oximetry in predicting arterial carbon dioxide partial pressure and arterial oxygen saturation may therefore be affected. The 35 ASA 1‐2 patients in this study comprised 12 men and 23 women aged 48 (SD 17) years and weighing 71 (SD 14) kg. Twenty‐nine were to undergo upper abdominal laparoscopy for cholecystectomy and six hyperselective vagotomy. Intra‐abdominal pressure was 1.7 (SD 0.9) kPa and head‐up tilt was 5.6 (SD 4.2)°. After abdominal insuflation, arterial carbon dioxide partial pressure significantly increased (p < 0.05). However, the arterial carbon dioxide partial pressure‐end‐tidal carbon dioxide partial pressure gradient remained constant throughout surgery. This gradient was highly correlated with arterial carbon dioxide partial pressure (p < 0.0001), but was not correlated with elapsed time, intra‐abdominal pressure or head‐up tilt. Arterial oxygen saturation was always greater than 95% in all patients and the arterial oxygen saturation‐pulse oximetric saturation gradient was always less than or equal to +4%. In conclusion, end‐tidal carbon dioxide partial pressure and pulse oximetric saturation allow reliable monitoring of arterial carbon dioxide partial pressure and arterial oxygen saturation in the absence of pre‐existing cardiopulmonary disease and/or acute peroperative disturbance.