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Acta Anaesthesiol Scand. 1997 Mar;41(3):408-13.

Changes in pulmonary mechanics during laparoscopic gastroplasty in morbidly obese patients.

Author information

1
Department of Anesthesiology, Brugmann University Hospital, Brussels, Belgium.

Abstract

BACKGROUND:

Obesity is an important respiratory risk factor after abdominal surgery. Laparoscopic surgical techniques seem beneficial in obese patients in terms of respiratory morbidity, with a faster return to normal respiratory function. However, there is little information about intraoperative respiratory mechanics and about patient tolerance to abdominal insufflation in the morbidly obese.

METHODS:

We studied respiratory mechanics and arterial blood gases in 15 morbidly obese patients (mean BMI = 45) undergoing laparoscopic gastroplasty under general anaesthesia and controlled ventilation. Respiratory mechanics were analysed using side-stream spirometry.

RESULTS:

When compared to preinsufflation values, servocontrolled abdominal insufflation to 2.26 kPa caused a significant decrease in respiratory system compliance (31%), a significant increase in peak (17%) and plateau (32%) airway pressures at constant tidal volume with a significant hypercapnia but no change in arterial O2 saturation. Respiratory system compliance and pulmonary insufflation pressures returned to baseline values after abdominal deflation.

CONCLUSION:

These alterations in pulmonary mechanics are less than those observed with comparable degrees of abdominal inflation in non-obese patients, and were well tolerated. From the point of view of intraoperative respiratory mechanics, laparoscopic surgery is safe in morbidly obese patients.

PMID:
9113188
[Indexed for MEDLINE]

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