A Comparative Study of Effects of Pressure & Volume Controlled v Entilation in Laparoscopic Surgery

The historical milestone in evolution of laparoscopic surgery have been comprehensively detailed by Gaskin et al. 1 The advent of laparoscopic cholecystectomy was the catalyst that aroused the interest of general surgeon worldwide in laparoscopy and closed abdominal surgery. 3] The creation of pneumoperitoneum by insufflation of the abdominal cavity with CO2 and assumption of trendelenburg position have several haemodynamic & respiratory consequences. This study was undertaken to compare effects of pressure controlled ventilation & volume controlled ventilation in laparoscopic surgery in view of haemodynamic and respiratory parameters. AIMS: To find out the better mode between volume & pressure controlled ventilation regarding changes in haemodynamic and respiratory parameters in laparoscopic surgery. METHODS & MATERIALS: We observed 140 patients undergoing laparoscopic surgery in general anesthesia with endotracheal intubation of ASA Grade I & II. 70 patients were assigned in each mode of ventilation by the method of presealed envelope drawn by an independent observer. Haemodynamic and respiratory parameters were recorded after tracheal intubation (T0) and then after creation of pneumoperitoneum at every 10 min upto 80 min. The tidal volume was kept @7ml/kg in volume controlled mode and in pressure controlled mode the pressure was kept in such a way that it reaches the tidal volume @7ml/kg. Data was analysed by SpSS software ver.15. p<.05 was considered significant. The haemodynamic parameters such as heart rate, systolic blood pressure, diastolic blood pressure & mean arterial pressure were recorded. The ventilatory parameters end tidal carbon dioxide (EtCo2), peak & plateau pressure were recorded at prepneumoperitoneum, at pneumoperitoneum and post pneumoperitoneum. RESULTS: The incidence of variation in haemodyanamic and respiratory parameters were observed least changes in pressure controlled ventilation as compared to volume controlled ventilation in laparoscopic surgery undergoing general anesthesia. The p Values was <.05 at all-time points which is statistical significant. CONCLUSION: Pressure controlled ventilation was better mode of ventilation than volume controlled ventilation in laparoscopic surgery in view of respiratory and haemodynamic variation.