Minimal impairment in pulmonary function following laparoscopic surgery
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Minimal impairment in pulmonary function following laparoscopic surgery. / Staehr-Rye, Anne K; Rasmussen, L S; Rosenberg, J; Steen-Hansen, C; Nielsen, T F; Rosenstock, C V; Clausen, Helle V; Sørensen, Martin Kryspin; Regeur, Jakob von Halling; Gätke, M R.
In: Acta Anaesthesiologica Scandinavica, Vol. 58, No. 2, 02.2014, p. 198-205.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Minimal impairment in pulmonary function following laparoscopic surgery
AU - Staehr-Rye, Anne K
AU - Rasmussen, L S
AU - Rosenberg, J
AU - Steen-Hansen, C
AU - Nielsen, T F
AU - Rosenstock, C V
AU - Clausen, Helle V
AU - Sørensen, Martin Kryspin
AU - Regeur, Jakob von Halling
AU - Gätke, M R
N1 - © 2014 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
PY - 2014/2
Y1 - 2014/2
N2 - BACKGROUND: Pulmonary function may be impaired in connection with laparoscopic surgery, especially in the head-down body position, but the clinical importance has not been assessed in detail. The aim of this study was to assess pulmonary function after laparoscopic hysterectomy and laparoscopic cholecystectomy. We hypothesised that arterial oxygenation would be more impaired after hysterectomy performed in the head-down position than after cholecystectomy in the head-up position.METHODS: We included 60 women in this prospective, observational study. The patients underwent elective laparoscopic cholecystectomy in the 20° head-up position or hysterectomy in the 30° head-down position. The primary outcome was the difference between arterial oxygenation (PaO2 ) 2 h postoperatively and the preoperative value. Two hours and 24 h after surgery, pulmonary shunt and ventilation-perfusion mismatch were assessed by use of an automatic lung parameter estimation system.RESULTS: Two hours after surgery, the mean change from baseline in PaO2 was -0.65 kPa [95% confidence interval (CI) -3.5 to 3.4, P = 0.14] in the hysterectomy group and -0.22 kPa [95% CI -3.4 to 2.0, P = 0.12] in the cholecystectomy group (P = 0.88). Shunt was significantly greater in the cholecystectomy group 24 h after surgery compared to the hysterectomy group [4%, 95% CI 0 to 9 vs. 0%, 95% CI 0 to 7, P = 0.02].CONCLUSIONS: Minimal impairment in pulmonary gas exchange was found after laparoscopic surgery. Pulmonary shunt was larger after laparoscopic cholecystectomy, but no clinically significant differences in postoperative pulmonary gas exchange or spirometry were found between laparoscopic hysterectomy and laparoscopic cholecystectomy.
AB - BACKGROUND: Pulmonary function may be impaired in connection with laparoscopic surgery, especially in the head-down body position, but the clinical importance has not been assessed in detail. The aim of this study was to assess pulmonary function after laparoscopic hysterectomy and laparoscopic cholecystectomy. We hypothesised that arterial oxygenation would be more impaired after hysterectomy performed in the head-down position than after cholecystectomy in the head-up position.METHODS: We included 60 women in this prospective, observational study. The patients underwent elective laparoscopic cholecystectomy in the 20° head-up position or hysterectomy in the 30° head-down position. The primary outcome was the difference between arterial oxygenation (PaO2 ) 2 h postoperatively and the preoperative value. Two hours and 24 h after surgery, pulmonary shunt and ventilation-perfusion mismatch were assessed by use of an automatic lung parameter estimation system.RESULTS: Two hours after surgery, the mean change from baseline in PaO2 was -0.65 kPa [95% confidence interval (CI) -3.5 to 3.4, P = 0.14] in the hysterectomy group and -0.22 kPa [95% CI -3.4 to 2.0, P = 0.12] in the cholecystectomy group (P = 0.88). Shunt was significantly greater in the cholecystectomy group 24 h after surgery compared to the hysterectomy group [4%, 95% CI 0 to 9 vs. 0%, 95% CI 0 to 7, P = 0.02].CONCLUSIONS: Minimal impairment in pulmonary gas exchange was found after laparoscopic surgery. Pulmonary shunt was larger after laparoscopic cholecystectomy, but no clinically significant differences in postoperative pulmonary gas exchange or spirometry were found between laparoscopic hysterectomy and laparoscopic cholecystectomy.
KW - Adult
KW - Aged
KW - Anesthesia, General
KW - Cholecystectomy, Laparoscopic
KW - Female
KW - Forced Expiratory Volume
KW - Humans
KW - Hysterectomy
KW - Laparoscopy
KW - Lung
KW - Lung Diseases
KW - Oxygen
KW - Pain Measurement
KW - Pain, Postoperative
KW - Patient Positioning
KW - Postoperative Complications
KW - Prospective Studies
KW - Respiratory Function Tests
KW - Spirometry
KW - Treatment Outcome
KW - Vital Capacity
U2 - 10.1111/aas.12254
DO - 10.1111/aas.12254
M3 - Journal article
C2 - 24383568
VL - 58
SP - 198
EP - 205
JO - Acta Anaesthesiologica Scandinavica
JF - Acta Anaesthesiologica Scandinavica
SN - 0001-5172
IS - 2
ER -
ID: 138222068