[Anesthesia relevant features of laparoscopy--the value of capnometry]

End-expiratory capnometrical and capnographical data correspond well with blood carbon dioxide content. Carbon dioxide insufflation for laparoscopy results in a big increase in CO2 uptake as well as in respiratory deterioration due to positioning and increased intra-abdominal pressure. We observed 226 female patients during laparoscopy under general anaesthesia (midazolam-alfentanil-atracurium or vecuronium) and artificial ventilation. Airway peak and plateau pressure increased by about 75% as compared to pre-insufflation levels. End-tidal carbon dioxide exceeded pre-insufflation levels by 2 to 19 mmHg (mean 9 mmHg). Both findings were correlated to speed and overall volume of CO2 insufflation. Major cardiocirculatory side-effects were not observed, except for rare bradycardia, which responded to atropine. Considerable regurgitation via or beneath the gastric tube occurred in 52%. Thus, general anaesthesia with endotracheal intubation and consistent monitoring, including capnometry, may be regarded as particularly safe as far as aspiration of gastric contents and ventilatory requirements are concerned.