Pressure Control Ventilation Versus Volume Control Ventilation in Laparoscopic Surgery: A Narrative Review

Area of Science:

• Anesthesiology
• Respiratory Medicine
• Surgical Innovation

Background:

• Laparoscopic surgery presents unique challenges for mechanical ventilation due to increased intra-abdominal pressure.
• Volume Control Ventilation (VCV) and Pressure Control Ventilation (PCV) are common modes with distinct physiological effects.

Purpose of the Study:

• To compare the safety and effectiveness of VCV and PCV in the context of laparoscopic surgery.
• To review current literature and provide insights into optimal ventilation strategies.

Main Methods:

• Systematic review of nine studies selected from 184 initial publications.
• Application of stringent inclusion and exclusion criteria for study selection.

Main Results:

• PCV demonstrates potential for lower peak airway pressures, reducing risks of volutrauma and barotrauma, and improving oxygenation.
• VCV ensures precise tidal volume delivery, crucial for stable carbon dioxide levels, but may lead to higher airway pressures.
• PCV generally offers better respiratory mechanics management, while VCV's consistent delivery is beneficial in specific scenarios.

Conclusions:

• The choice between PCV and VCV should be individualized, considering anesthesia team expertise, patient status, and surgical demands.
• Advanced monitoring and multimodal anesthesia, including muscle relaxants and tailored fluid management, are vital for optimizing outcomes.
• PCV appears more advantageous for managing oxygenation and airway pressures, but ongoing research is essential for refining ventilation strategies in laparoscopic surgery.