Prospective Comparative Analysis of Intra-operative Factors Influencing Outcome in Abdominal Surgeries

Abstract

Introduction: All abdominal (either laparoscopic or open) surgeries need intra operative monitoring of Oxygen saturation(SpO2), mean blood pressure, End tidal carbon dioxide (ETCO2) and blood loss. This monitoring is vital to prevent intra operative adverse events. Blood loss must be monitored and has to be replaced whenever essential. The objectives of the study is 1. To find the difference in intra operative factors like SpO2, mean blood pressure, ETCO2 , and blood loss between open and laparoscopic surgeries Materials and methods: This was a prospective observational study was performed over a period of 12 months from October’ 2018 to October 2019. All abdominal surgeries (either laparoscopic or open surgeries) performed at department of surgical oncology, Government Royapettah Hospital, Tamilnadu, Chennai were included in the study. All patients were given anesthesia by ETGA and monitored values recorded intra operatively. ETCO2, Blood Pressure, SPO2 and blood loss were recorded. These factors were compared between open and laparoscopic surgeries. Results were analyzed using standard statistical methods. Results: There were no statistically significant differences noted in SPO2, Mean BP and ETCO2, between all abdominal surgeries. Mean blood loss noted was 160.5ml, 192.7ml; 300.5ml in laparoscopic, lap assisted and open abdominal surgeries respectively.Hypotension was found more among open surgeries (51%) compared to laparoscopic (18%) or lap assisted (18%) abdominal surgeries (p=0.004). ETCO2 values >35 were recorded in 68%, 41%, 38% in laparoscopic, lap assisted and open abdominal surgeries respectively. Conclusions: We concluded that there was no statistical difference noted in intra-operative factors SPO2, Mean BP, ETCO2, between all abdominal surgeries. Mean blood loss, hypotension and blood transfusions were noted more among open than laparoscopic abdominal surgeries. Hypotension was significantly associated with open surgeries compared with laparoscopic abdominal surgeries. Key words: Intraoperative factors; ETCO2; laparoscopy Vs open surgeries.