Comparison Between Volume Controlled Ventilation and Pressure Controlled Ventilation in Laparoscopic Cholecystectomy and their Effects on Hemodynamic and Respiratory Parameters

Abstract

Background: Laparoscopic cholecystectomy is a minimally invasive surgical technique for amputation of anunhealthy gallbladder. This procedure has several advantages including shorter stay in hospital, minimal postoperativepain and fast recovery after procedure. The disadvantages of this procedure due to increase intraabdominalpressure, patient position and general anesthesia. Many of anesthetist apply VCV in this procedure.VCV can deliver adequate minute volume but this is corresponded by an increase in airway pressure, so otheralternative mode can be used to solve this problem like PCV.Aim of the Study: To compare effect of volume controlled ventilation versus pressure controlled ventilation onrespiratory and haemodynamic parameters during laproscopic cholycystectomy.Patients and method: A prospective comparative observational study, conducted at the Department of generalsurgery in Baghdad Teaching Hospital/Medical city complex, from October 2019 - October 2020. Fifty participantsunderwent laparoscopic cholecystectomy within the inclusion criteria were included in the present study. Eachgroup consist of 25 patients .one group received VCV and others receive PCV. peak airway pressure, mean airwaypressure, MAP, and heart rate was recorded intraoperatively at 5,10 and 30 minute intervals. The collected datawere analyzed by SSPS version 22 program.Results: In pressure control group of patients, the peak airway pressure was significantly deceased after 10 and30minutes after start of laparoscopy (20.2and 20.8) versus (24.3 and 24.1) respectively and mean airway pressurewas significantly increased after same time (10.6 and10.6) versus (9.7 and 9.7) respectively relative to volumecontrol group. No significant change in hemodynamic parameters. Conclusion: PCV mode is a safe alternative &offers protection to the lungs but there was no beneficial effect of PCV regarding mean airway pressures whichreflect oxygenation, minute ventilation &ETCO2.