Abstract
Arterial blood was sampled from 10 anaesthetized, spontaneously breathing patients before, during and after pelvic laparoscopy using N2O as the insufflating gas. There was little change in Paco2 during the procedure. With an inspired oxygen concentration of approximately 37%, the mean Pao2 decreased during laparoscopy from 163 mm Hg (±24 mm Hg) to 146 mm Hg (±28 mm Hg). In the postoperative period, with the patients breathing room air, the mean Pao2 was 78 mm Hg (± 10 mm Hg). In 2 other patients, who were heavy smokers, arterial Pao2 decreased to less than 100 mm Hg during laparoscopy and the mean Pao2 in the postoperative period with the patients breathing room air was 49 mm Hg (±0.07 mm Hg). One of these patients had significant airflow obstruction and impaired gas transfer. It is concluded that spontaneous ventilation during pelvic laparoscopy may be unsuitable for patients with lung disease, and that arterial hypoxaemia may occur in patients with apparently normal lung function.
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