Open AccessChanges of diaphragmatic excursion and lung compliance during major laparoscopic pelvic surgery: A prospective observational study
Author(s) -
Kyungmi Kim,
Dong-Min Jang,
Jong Yeon Park,
Hwanhee Yoo,
Hong Soon Kim,
Woo-Young Choi
Publication year - 2018
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0207841
Subject(s) - medicine , pneumoperitoneum , trendelenburg position , anesthesia , pulmonary compliance , intubation , diaphragmatic breathing , surgery , muscle relaxation , laparoscopic surgery , sedation , trendelenburg , laparoscopy , lung , alternative medicine , pathology
Major laparoscopic pelvic surgery requires steep Trendelenburg position with pneumoperitoneum for a long time. We investigated the effect of Trendelenburg position with pneumoperitoneum on diaphragmatic excursion and lung compliance during major laparoscopic pelvic surgery using M-mode sonography. Twenty patients undergoing elective pelviscopic radical hysterectomy were included in this study. Diaphragmatic excursion was measured at the following time points; after sedation, after intubation, 90 minutes after Trendelenburg position with pneumoperitoneum, and after operation with recovery of muscle relaxation. And lung compliance was measured using anesthetic machine under general anesthesia; after the intubation, 90 minutes after Trendelenburg position with pneumoperitoneum and after operation with recovery of muscle relaxation. In order to detect postoperative pulmonary complication, postoperative chest radiography was checked. Static lung compliance, dynamic lung compliance and diaphragmatic excursion were decreased during operation ( P < 0.001, respectively). At the end of the operation with recovery of muscle relaxation, reduced diaphragmatic movement was not recovered as its excursion after sedation ( P < 0.001). In conclusion, lung compliance was decreased following transiently decreased diaphragmatic excursion during major laparoscopic pelvic surgery.