Effect of pressure-controlled recruitment maneuver onhemodynamics and respiratory mechanics during pneumoperitoneum

Abstract

Introduction: Laparoscopic surgery has become an increasingly preferred method due to the small sizeof the abdominal incision line, causing less tissue trauma, reduced post-operative analgesic requirement,providing early mobilization, decreased post-operative ileus, and shortened hospital stay. However, pneu moperitoneum may cause upward displacement of the diaphragm by increasing intra-abdominal pressure,decrease functional residual capacity and lung compliance, and develop atelectasis. The aim of this study isto investigate the effect of recruitment maneuver and positive end expiratory pressure (PEEP) applicationsperformed together with graduated pressure levels and low O2concentration on respiratory mechanics, oxy genation, and hemodynamic parameters in patients who underwent laparoscopic cholecystectomy. Materials and Methods: Sixty patients with laparoscopic surgery and ASA I and II were divided into three groups(n=20 in each group). Recruitment maneuvers were performed in the patients in Group R with a stepwise methodtwice, 5 min after insufflation and desufflation. While the patients were at 8 cmH2 O PEEP value, they were ven tilated 10 times with 5 cmH2 O 0.05). Compliance measurements of thecases in Group R 5 min after desuflation were found to be significantly higher than the cases in Groups P and C. Conclusion: It is thought that recruitment maneuver and PEEP application with gradually increasing pres sure in patients undergoing laparoscopic surgery have positive effects on oxygenation, increases lung com pliance and can be used safel