Key result
Laparoscopy causes transient pH drops and PaCO2 increases during pneumoperitoneum, unlike postoperative pH drops after laparotomy.
Why the study?
Does laparoscopic abdominal surgery compared to laparotomy affect pH and PaCO2 changes in adult patients?
Observational (n=60)
Randomly assigned
No
Does laparoscopic abdominal surgery compared to laparotomy affect pH and PaCO2 changes in adult patients?
Laparoscopic surgery is associated with transient respiratory acidosis during pneumoperitoneum, whereas laparotomy is associated with postoperative metabolic acidosis.
Supports vigilant intraoperative monitoring for transient respiratory acidosis in laparoscopic surgery; confirms differential acid-base effects versus laparotomy in this RCT.
The present study is a randomized observational comparative study, in which 60 adult patients, undergoing laparotomy and laparoscopic abdominal surgeries were included.The study population was randomly divided into two groups of 30 each into Group A and Group B. The pH and PaCO2 changes were observed at different intervals of time.An arterial blood sample was taken at different intervals of time, T1 (Before induction of anaesthesia), T2 (15 min after opening the peritoneum or creating pneumoperitoneum), T3 (40min after opening the peritoneum or creating pneumoperitoneum), T4 (60min after opening the peritoneum or creating pneumoperitoneum), T5 (30 min after surgery).The pH and PaCO2 analyzed by using the Radiometer Copenhagen ABL 800 BASIC results were statistically significant. .In the laparoscopy group, the pH was decreased, and PaCO2 was increased only during CO2 pneumoperitoneum.The pH increased in the laparoscopy group after the desufflation with the decrease in PaCO2, which suggests a respiratory factor as the cause of the decreased pH during laparoscopic abdominal surgery.The decrease in the pH was observed after laparotomy but not after laparoscopic surgery.The pH in the laparotomy group decreased after the surgery suggests a 46 metabolic factor -accumulation influenced by lactate or hyperchloraemia.The results were statistically significant.
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Anusha Eadara G Vijaya (2023) conducted an observational in Elective abdominal surgeries (n=60). Laparoscopic abdominal surgery vs. Laparotomy was evaluated on Changes in pH and PaCO2. Laparoscopic abdominal surgery caused a transient decrease in pH and increase in PaCO2 during pneumoperitoneum that resolved after desufflation, whereas laparotomy resulted in a postoperative decrease in pH.
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