Effect of insufflated CO2 during laparoscopic surgeries on end tidal CO2 concentration using capnography

Abstract

Use of laparoscopic surgeries become a best alternate for laparotomy and is used for the diagnostic as well as therapeutic purposes in patients presented for gynecological surgeries. Advantages include; reduction in postoperative persistent obstruction of intestine, aches, hospitalization, health expenses and problems relating to surgical wounds. Its procedure includes a brief period of intraperitoneal carbon dioxide (CO2) insufflation. Although this insufflation of carbon dioxide (CO2) is continued for a very short period of time causes deleterious physiological changes in respiratory system, lung volumes and gas exchange through alveoli. Purpose of conducting the study to understand the determination of effect of blowing of CO2 to intraperitoneal cavity during laparoscopic surgeries on end tidal CO2. A prospective descriptive study was done after the ethical approval from the concerned departments. End tidal CO2 (EtCO2) concentration was recorded in intervals at pre-induction of anesthesia before insufflation and termed this as baseline concentration of the said gas, then recorded at 10-mmHg, between 10-15 mmHg, at 15-mmHg of intraperitoneal pressure and at the cessation of the surgery. End tidal CO2 (EtCO2) after CO2 insufflation during laparoscopic surgeries is compared with the baseline EtCO2. Upon assessing the data, EtCO2 increased slightly after CO2 insufflation and considerably after the surgical incision. After completion of the laparoscopic surgery, the EtCO2 exhibited a trend to baseline value. This study concludes that the patients who were otherwise healthy and were just undergoing laparoscopic surgeries, EtCO2 surges slightly subsequent to CO2 insufflation and readily comes to baseline value.