Brazilian Journal of Anesthesiology
https://app.periodikos.com.br/journal/rba/article/doi/10.1016/j.bjane.2015.12.003
Brazilian Journal of Anesthesiology
Scientific Article

Functional residual capacity increase during laparoscopic surgery with abdominal wall lift

Aumento da capacidade residual funcional durante cirurgia laparoscópica com elevação da parede abdominal

Hiroshi Ueda; Takuo Hoshi

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Abstract

Abstract Background and objectives: The number of laparoscopic surgeries performed is increasing every year and in most cases the pneumoperitoneum method is used. One alternative is the abdominal wall lifting method and this study was undertaken to evaluate changes of functional residual capacity during the abdominal wall lift procedure. Methods: From January to April 2013, 20 patients underwent laparoscopic cholecystectomy at a single institution. All patients were anesthetized using propofol, remifentanil and rocuronium. FRC was measured automatically by Engstrom Carestation before the abdominal wall lift and again 15 minutes after the start of the procedure. Results: After abdominal wall lift, there was a significant increase in functional residual capacity values (before abdominal wall lift 1.48 × 103 mL, after abdominal wall lift 1.64 × 103 mL) (p < 0.0001). No complications such as desaturation were observed in any patient during this study. Conclusions: Laparoscopic surgery with abdominal wall lift may be appropriate for patients who have risk factors such as obesity and respiratory disease.

Keywords

Abdominal wall lift, Functional residual capacity, Laparoscopic surgery

Resumo

Resumo Justificativa e objetivos: O número de cirurgias laparoscópicas feitas tem aumentado a cada ano e, na maioria dos casos, o método com pneumoperitônio é o escolhido. Uma opção é o método de elevação da parede abdominal. Este estudo foi feito para avaliar as alterações da capacidade residual funcional durante o procedimento de elevação da parede abdominal. Métodos: De janeiro a abril de 2013, 20 pacientes foram submetidos à colecistectomia laparoscópica em uma única instituição. Todos foram anestesiados com propofol, remifentanil e rocurônio. A CRF foi medida automaticamente com o Engström Carestation antes da elevação da parede abdominal e, novamente, 15 minutos após o início do procedimento. Resultados: Após elevar a parede abdominal, um aumento significativo foi observado nos valores da capacidade residual funcional (antes da elevação da parede abdominal: 1,48 × 103 mL: após a elevação da parede abdominal: 1,64 × 103 mL) (p <0,0001). Não houve complicações, como dessaturação, em nenhum paciente durante este estudo. Conclusões: A cirurgia laparoscópica com elevador da parede abdominal pode ser apropriada para pacientes com fatores de risco como obesidade e doenças respiratórias.

Palavras-chave

Elevador da parede abdominal, Capacidade residual funcional, Cirurgia laparoscópica

References

Craig DB, Wahba WM, Don HF. "Closing volume" and its relationship to gas exchange in seated and supine position. J Appl Physiol. 1971;31:717-21.

Westbrook PR, Stubbs SE, Sessler AD. Effects of anesthesia and muscle paralysis on respiratory mechanics in normal man. J Appl Physiol. 1973;34:81-6.

Don HF, Wahba WM, Cuadrado L. The effects of anesthesia and 100 percent oxygen on the functional residual capacity of the lungs. Anesthesiology. 1970;32:521-9.

Rauh R, Hemmerling TM, Rist M. Influence of pneumoperitoneum and patient positioning on respiratory system compliance. J Clin Anesth. 2001;13:361-5.

Matsumoto K. Changes in thorax-lung compliance during general anesthesia with mechanical ventilation in response to various intraoperative maneuvers. Masui. 2006;55:704-7.

Kanaya A, Satoh D, Kurosawa S. Higher fraction of inspired oxygen in anesthesia induction does not affect functional study residual capacity reduction after intubation: a comparative study of higher and lower oxygen concentration. J Anesth. 2013;27:385-9.

Ren H, Tong Y, Ding XB. Abdominal wall-lifting versus CO2 pneumoperitoneum in laparoscopy: a review and met-analysis. Int J Clin Exp Med. 2014;7:1558-68.

Grace PA, Quereshi A, Coleman J. Reduced postoperative hospitalization after laparoscopic cholecystectomy. Br J Surg. 1991;78:160-2.

Johnson D, Litwin D, Osachoff J. Postoperative respiratory function after laparoscopic cholecystectomy. Surg Laparosc Endosc. 1992;2:221-6.

Eichenberger A, Proietti S, Wicky S. Morbid obesity and postoperative pulmonary atelectasis: an underestimated problem. Anesth Analg. 2002;95:1788-92.

Brown R, Leith DE, Enright PL. Multiple breath helium dilution measurement of lung volumes in adults. Eur Respir J. 1998;11:246-55.

Mitchell RR, Wilson RM, Holzapfel L. Oxygen wash-in method for monitoring functional residual capacity. Crit Care Med. 1982;10:529-33.

Newth CJL, Enright P, Johnson RL. Multiple-breath nitrogen washout techniques: including measurements with patients on ventilators. Eur Respir J. 1997;10:2174-85.

Chiumello D, Cressoni M, Chierichetti M. Nitrogen washout/washin, helium dilution and computed tomography in the assessment of end expiratory lung volume. Crit Care. 2008;12:R150.

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