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Increased carbon dioxide absorption during retroperitoneal laparoscopy
B Streich1, F Decailliot, C Perney
1Department of Anesthesiology and Intensive Care Unit, Henri Mondor Hospital, 51 avenue Marechal de Lattre de Tassigny, 94010 Creteil, France.
Background:
Retroperitoneoscopy for renal surgery is now a common procedure. We compared carbon dioxide absorption in patients undergoing retroperitoneoscopy for adrenal or renal surgery with that of patients undergoing laparoscopic cholecystectomy.
Methods:
We measured carbon dioxide elimination with a metabolic monitor in 30 anaesthetized patients with controlled ventilation, undergoing retroperitoneoscopy (n=10), laparoscopy (n=10) or orthopaedic surgery (n=10).
Results:
Carbon dioxide production increased by 38, 46 and 63% at 30, 60 and 90 min after insufflation (P<0.01) in patients having retroperitoneoscopy. Carbon dioxide production (mean (SD)) increased from 92 (21) to 150 (43) ml x min(-1) m(-2) 60-90 min after insufflation and remained increased after the end of insufflation. During laparoscopy, V(.)(CO(2)) increased less (by 15%) (P<0.05 compared with retroperitoneoscopy) and remained steady throughout the procedure.
Conclusion:
Retroperitoneal carbon dioxide insufflation causes more carbon dioxide absorption than intraperitoneal insufflation, and controlled ventilation should be increased if hypercapnia should be avoided.
