Key result
Pressure-controlled ventilation raises peak airway pressure by ~15% over volume-controlled ventilation despite higher tidal volumes.
Why the study?
Most patients undergoing eye surgery are elderly with cardiovascular diseases, and gastric insufflation during recovery can cause detrimental effects; comparison of volume-controlled and pressure-controlled ventilation methods is needed.
Cross-Sectional (n=81)
Open-label
No
Absolute Event Rate: 16.65% vs 14.44%
p-value: p=0.014
May inform ventilation mode choice for laryngeal mask airway in cataract surgery; leaves open effects on outcomes in larger trials.
Introduction: Most patients undergoing eye surgery are elderly adults with underlying cardiovascular diseases. One of the complications during recovery is gastric insufflation, which can cause detrimental effects on cardiovascular patients. The present study compares two methods of volume-controlled ventilation (VCV) and pressure-controlled ventilation (PCV). Methods: The study enrolled 81 patients undergoing cataract surgery (41 in the PCV group and 40 in the VCV group). According to the American Society of Anaesthesiologists (ASA) classes I and II received general anaesthesia and laryngeal mask airway (LMA) ventilation using VCV or PCV. Maximum pressure (Ppeak), dynamic compliance, expiratory tidal volume, Spo2, non-invasive blood pressure, heart rate, and pain in the epigastrium and umbilical region were monitored at intervals of 1, 5, 10, and 20 minutes after the initiation of anaesthesia and the results of two groups were compared. Results: The means of Ppeak and tidal volume in the PCV group as well as the means of dynamic compliance and end-tidal carbon dioxide (EtCO2) in the VCV group were significantly high. The mean diastolic blood pressure was significantly different between two groups at 20th minute. There were no significant differences in heart rate, mean systolic blood pressure, arterial oxygen saturation, or abdominal pain between two study groups. Conclusion: VCV had a lower Ppeak and a higher dynamic compliance, but PCV had a larger tidal volume and lower EtCO2. There were no differences in terms of abdominal and umbilicus pain, as well as hemodynamic parameters, between two groups.
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Saghezchi et al. (2023) conducted a cross-sectional in Cataract (n=81). Pressure-controlled ventilation (PCV) vs. Volume-controlled ventilation (VCV) was evaluated on Peak airway pressure (Ppeak) at 1 minute (cm H2O) (p=0.014). Pressure-controlled ventilation resulted in higher peak airway pressure and lower dynamic compliance, but provided a larger tidal volume and lower end-tidal carbon dioxide compared to volume-controlled ventilation.
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