Application of PRVC in laparoscopic surgery

Abstract

Objective: To discuss the clinical significance and value of PRVC by monitoring, comparing and studying pressure control (PC), volume control (VC) and pressure-regulated volume control (PRVC) ventilation modes during pneumoperitoneum. Methods: Ninety patients with laparoscopic cholecystectomy were randomly and equally divided into 3 groups (PC group, VC group and PRVC group). Esophageal pressure (PES), mean airway pressure (PAWM), peak airway pressure (PAP), arterial blood carbon dioxide partial pressure (PaCO 2 ), end-tidal carbon dioxide concentration in the expired air (ETCO 2 ), tidal volume (TV), mean arterial pressure (MAP) and heart rate (HR) were not only detected before pneumoperitoneum, but also in 5, 10, 15 and 20 minutes after pneumoperitoneum. Results: PES after pneumoperitoneum in VC mode was obviously higher than that in PC and PRVC groups. In 10 minutes after pneumoperitoneum, levels of PaCO 2 and ETCO 2 became increased obviously in PC and VC groups ( p < .05); levels of PaCO 2 and ETCO 2 were not only increased in PC group, but also the level of TV after pneumoperitoneum in PC group was significantly lower than that in the other two groups ( p < .05). Levels of PaCO 2 and ETCO 2 were increased in PC and VC groups after pneumoperitoneum, along with the increase of MAP and HR ( p < .05). After pneumoperitoneum, levels of MAP and HR in PRVC group were significantly lower than those in PC and VC groups ( p < .05). Conclusions: PRVC mode can effectively reduce the pneumoperitoneum-induced increase of PAWM, PAP and PES without the unusual increase of PaCO 2 and ETCO 2 during surgery, so as to guarantee the stability of vital signs in perioperative patients.