The safety of CO2 pneumoperitoneum for elderly patients during laparoscopic colorectal surgery

The aim of this study was to compare the anesthetic outcomes of elderly and younger patients perioperatively, and to evaluate the safety of this procedure in elderly.

A total of 25 patients undergoing elective laparoscopic colorectal surgery were enrolled in this study prospectively. Ten patients were more than or equal to 70 years (Group E) and 15 patients were less than or equal to 69 years (Group Y). The parameters between groups for perioperative hemodynamics, arterial blood chemistry, and perfusion of intraabdominal organs were recorded and compared periodically from before induction of anesthesia till after the operation.

Group E had a higher ASA degree (P<0.01) than group Y. During the operation, the HCO3 and PaCO2 value increased whereas the pH value decreased significantly. All these parameters recovered gradually at the end of the surgery; some serum electrolytes decreased, especially K and Ca. The central venous pressure increased after volume expansion and the beginning of operation, and then decreased postoperatively. Mean arterial pressure had a marked change during volume expansion period and early after the induction of anesthesia. pHi decreased when the operation began. PgCO2 increased significantly at the end of the surgery. Central venous pressure of group E was higher than that of group Y at 5 minutes during operation, whereas mean arterial pressure of elder group was lower than that of younger group at 15 minutes after the end of operation. Other hemodynamic parameters did not differ significantly from the results.

There is no significantly adverse effect for elderly patients during perioperative period. Adequate intraoperative administration and monitoring are beneficial for maintaining a safe anesthesia.