Acid-base alterations during laparoscopic abdominal surgery: a comparison with laparotomy

British Journal of Anaesthesia
H J KwakJ Y Kim

Abstract

Carbon dioxide insufflation during laparoscopic surgery results in an acid-base imbalance. The purpose of this study was to investigate the effect of pneumoperitoneum on the acid-base status using Stewart's approach. Thirty patients undergoing abdominal surgery were allocated to the laparotomy group (n=15) or the laparoscopy group (n=15). The acid-base parameters were measured 10 min after the induction (T1), 40 min after opening the peritoneum or pneumoperitoneum according to the group (T2), at the end of the surgery (T3), and 1 h after the surgery (T4). There were no significant differences in the standard base excess (SBE), strong ion gap, or anion gap between the two groups. In both groups, the SBE decreased at T2, T3, and T4 compared with baseline value. At T3 and T4 in the laparotomy group, the apparent strong ion difference (SIDa) and pH were decreased whereas the lactate and chloride were increased compared with their baseline values. At T2 in the laparoscopy group, the pH was decreased whereas Pa(CO(2)) was increased compared with their baseline values. The decrease in the pH during the pneumoperitoneum was affected by the increase in Pa(CO(2)), which promptly returned to a normal value after the desufflation. On the o...Continue Reading

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Citations

Jun 22, 2011·Acta Anaesthesiologica Scandinavica·C M StrangGöran Hedenstierna
Jan 4, 2012·Biometrical Journal. Biometrische Zeitschrift·Jean-Baptiste Lecomte, Christophe Laplanche
Jun 22, 2017·The Cochrane Database of Systematic Reviews·Tianwu YuLian Bai
Apr 25, 2018·Korean journal of anesthesiology·Hyun Jeong KwakYoun Yi Jo
Aug 29, 2013·Female Pelvic Medicine & Reconstructive Surgery·Cori-Ann HiraiSteven M Minaglia
Aug 12, 2017·Surgical Endoscopy·Oleh MatsevychColleen Aldous
Sep 14, 2017·International Anesthesiology Clinics·Michael J Scott, Richard D Urman
Mar 29, 2012·Female Pelvic Medicine & Reconstructive Surgery·Mary P FitzgeraldSteven Edelstein

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