Comparison of Intra-operative Pressure-Controlled Ventilation and Volume-Controlled Ventilation in Bariatric Surgery:...

Area of Science:

• Anesthesiology and Critical Care Medicine
• Surgical Oncology
• Obesity Medicine

Background:

• Mechanical ventilation presents unique challenges in obese patients during laparoscopic bariatric surgery.
• Comparing ventilation strategies is crucial for optimizing peri-operative care in this population.

Purpose of the Study:

• To compare pressure-controlled ventilation (PCV) with volume-controlled ventilation (VCV).
• To evaluate the effects on peripheral tissue oxygenation (PTO), respiratory function, hemodynamics, and complications.
• To assess outcomes in obese patients undergoing laparoscopic bariatric surgery.

Main Methods:

• A randomized study enrolled 60 obese patients undergoing gastric plication or sleeve gastrectomy.
• Patients were assigned to either PCV (n=32) or VCV (n=28) groups.
• Peri-operative data included arterial blood gas analysis, tissue oxygen saturation (StO2), respiratory function tests, hemodynamic status, fluid balance, and pain scores (Numeric Pain Rating Scale - NPRS).

Main Results:

• No significant differences were observed between PCV and VCV groups in pH, oxygen/carbon dioxide partial pressures, oxygen saturation, or lactate levels.
• Peri-operative tissue oxygen saturation (StO2) remained similar across both ventilation modes.
• Preoperative respiratory function, postoperative hemodynamic status, fluid balance, pain scores, and complication rates were comparable between the groups.

Conclusions:

• The choice between PCV and VCV did not influence oxygen delivery, respiratory function, or hemodynamic status in obese patients during laparoscopic bariatric surgery.
• Neither ventilation mode was associated with differences in postoperative pain or ventilation-related complications.
• Current evidence suggests ventilation mode selection has minimal impact on key peri-operative outcomes in this specific patient cohort.