Utilização da pressão positiva no pré e no intraoperatório de cirurgia bariátrica e seus efeitos sobre o tempo de extubação

Abstract

Background and objectiveto investigate the influence of intraoperative and preoperative airway positive pressure in the time of extubation in patients undergoing bariatric surgery. MethodRandomized clinical trial, in which 40 individuals with a body mass index between 40 and 55kg/m2, age between 25 and 55 years, nonsmokers, underwent bariatric surgery type Roux‐en‐Y gastric bypass by laparotomy and with normal preoperative pulmonary function were randomized into the following groups: G‐pre (n = 10): individuals who received treatment with noninvasive positive pressure before surgery for one hour, G‐intra (n = 10): individuals who received positive end‐expiratory pressure of 10cm H2O throughout the surgical procedure and G‐control (n = 20): not received any pre or intraoperative intervention. Following were recorded: time between induction of anesthesia and extubation, between the end of anesthesia and extubation, duration of mechanical ventilation, and time between extubation and discharge from the Post‐Anesthetic Recovery. Resultsthere was no statistical difference between groups. However, when applied to the Cohen coefficient, the use of positive end‐expiratory pressure of 10cm H2O during surgery showed a large effect on the time between the end of anesthesia and extubation. About this same time, the treatment performed preoperatively showed moderate effect. ConclusionThe use of positive end‐expiratory pressure of 10cm H2O in the intraoperative and positive pressure preoperatively, influenced the time of extubation of patients undergoing bariatric surgery.