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Clinical Trial
. 2003 Dec;97(6):1818-1823.
doi: 10.1213/01.ANE.0000087038.48696.6D.

The difference between intramural and arterial partial pressure of carbon dioxide increases significantly during laparoscopic cholecystectomy: the effect of thoracic epidural anesthesia

Koichiroh Nandate  1 , Masanori Ogata, Masahiro Nishimura, Takefumi Katsuki, Shinichi Kusuda, Kohji Okamoto, Naoki Nagata, Akio Shigematsu
Affiliations
Clinical Trial

The difference between intramural and arterial partial pressure of carbon dioxide increases significantly during laparoscopic cholecystectomy: the effect of thoracic epidural anesthesia

Koichiroh Nandate et al. Anesth Analg. 2003 Dec.

Abstract

We studied the effects of pneumoperitoneum on gastric submucosal perfusion metabolism during elective laparoscopic cholecystectomy (LASC) by measuring the PCO(2) gap, defined as the difference between intramucosal PCO(2) and arterial PCO(2), using gas tonometry in 20 patients. Furthermore, we examined whether thoracic epidural anesthesia (TEA) affects gastric submucosal perfusion metabolism during LASC. Patients were randomly allocated to receive general anesthesia (group G, n = 10) or general anesthesia combined with TEA (group E, n = 10). In both groups, the PCO(2) gap increased significantly during pneumoperitoneum and remained at this level until the end of surgery compared with the baseline value. There were no significant differences in PCO(2) gap values between the two groups at any time sampled. These results suggested that pneumoperitoneum significantly impaired gastric submucosal perfusion and metabolism and that TEA did not attenuate the impairment of gastric submucosal perfusion during or after pneumoperitoneum.

Implications: We investigated the effect of pneumoperitoneum on gastric submucosal perfusion by measuring PCO(2) gap with the use of gas tonometry. PCO(2) gap significantly increased during and after the pneumoperitoneum compared with the control level. Thoracic epidural anesthesia did not attenuate this inhibition.

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References

    1. Struthers A, Cuschieri A. Cardiovascular consequences of laparoscopic surgery. Lancet 1998; 352: 568–70.
    1. Joris JL, Noirot DP, Legrand MJ, et al. Hemodynamic changes during laparoscopic cholecystectomy. Anesth Analg 1993; 76: 1067–71.
    1. Mythen MG, Webb AR. Intraoperative gut mucosal hypoperfusion is associated with increased post-operative complications and cost. Intensive Care Med 1994; 20: 99–104.
    1. Fink MP. Gastrointestinal mucosal injury in experimental models of shock, trauma, and sepsis. Crit Care Med 1991; 19: 627–41.
    1. Fiddian-Green RG. Gastric intramucosal pH, tissue oxygenation and acid-base balance. Br J Anaesth 1995; 74: 591–606.

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