The role of ventilation mode using a laryngeal maskairway during gynecological laparoscopy on lungmechanics, hemodynamic response and blood gasanalysis

Background: There are two methods for ventilation in gynecological laparoscopy:volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV).Objective: To compare the lung mechanics, hemodynamic response and arterialblood gas analysis and gas exchange of two modes of VCV and PCV usinglaryngeal mask airway (LMA) at different time intervals.Materials and Methods: Sixty infertile women referred for diagnostic laparoscopy,based on ventilation mode, were randomly divided into two groups of VCV (tidalvolume: 10 ml/kg) and PCV. In the PCV group, ventilation was initiated with a peakairway pressure (tidal volume: 10 ml/kg, upper limit: 35 cm H2O). In both groups,the arterial blood samples were taken in several time intervals (5, 10 and 15 minafter LMA insertion) for blood gas evaluation. Also the lung mechanics parameterswere continuously monitored and were recorded at different time intervals.Results: There were no significant differences for patient’s age, weight, height andBMI in two groups. The peak and plateau airway pressure were significantly higherin VCV group compared to PCV group 5 and 10 min after insertion of LMA. PaO2was significantly higher after 10 and 15 min in VCV group compared to PCV group(p=0.005 and p=0.03, respectively). PaCO2 showed significant increase after 5 minin PCV group, but the differences were not significant after 10 and 15 min in twogroups. The end tidal CO2 showed significant increase after 10 and 15 min in VCVcompared to PCV group.Conclusion: Both VCV and PCV seem to be suitable for gynecologicallaparoscopy. However, airway pressures are significantly lower in PCV compared toVCV

کلیدواژه ها:

Gynecologic laparoscopy ، Laryngeal mask airway ، Volume controlled ventilation ، Pressure controlled ventilation