Laparoskopik Kolesistektomi Operasyonlarinda PEEP Uygulamasının Arteriyel Oksijenasyon ve Dakika Ventilasyonu Üzerine Etkileri

Year 2016, Volume: 2 Issue: 1, 37 - 57, 01.04.2016

SONER Altıner AYŞENUR Altıner AYŞIN Ersoy AYSEL Altan

Abstract

Laporoskopik kolesistektomi tekniğine bağlı olarak, CO2

pnömoperitonyumu ve artmış intraarteryal basinç (İAB); mekanik,

hemodinamik ve respiratuar yan etkileri ortaya çıkarmakta, bu da

hipoksemi, hiperkapni, hemodinamik instabilite ve oksijenasyonda

bozulmaya neden olabilmektedir. Temel problemler; fonksiyonel rezidüel

kapasitenin azalması, ventilasyon/perfüzyon dengesinin bozulması ve

peritondan emilen CO2 nin sempatik stümülasyona yol açmasıdır. Bu

fizyopatolojik mekanizmalar perioperatif dönemde mekanik ventilasyon

uygulamasının ve uygulanacak anestezik yöntemin gözden geçirilmesini

gerektirir.

Keywords

peritondan, mekanizma, yöntem, method, ventilasyon, anestezik

References

• [1] Bosch F, Wehrman U, Saeger HD, Kirch W. Laparoscopic or open conventional cholecystectomy: clinical and economic considerations. Eur J Surg 2002; 168:270-277. [2] McDermott JP, Regan MC, Page R, et al. Cardiorespiratory effects of laparoscopy with and without gas insufflation. Arch Surg 1995; 130:984-988. [3] Mutoh T, Lamm WJ, Embree LJ, Hildebrandt J, Albert RK. Abdominal distension alters regional pleural pressures and chest wall mechanics in pigs in vivo. J Appl Physiol 1991; 70:2611-2618. [4] Wittgen CM, Charles HA, Stephen DF. Analysis of the hemodynamic and ventilatory effects of laparoscopic cholecystectomy. Arch. Surg. 1991;126:997-1001. [5] Weisman İM, Rinaldo JE, Rogers RM. Positive end-expiratory pressure in adult respiratory failure. The New England Journal of Medicine. 1982;307:1381-1384. [6] Tekant Y. Laparoskopik cerrahi. Sayek İ. (ed). Temel Cerrahi. Ankara Güneş Kitabevi. 1996; 1609-1617. [7] Langenbuch C. Ein Fall Von Exterpation der Gallenblase wegen chronischer cholelthiasis. Heilung, Klin Wachenschr 1882; 19:725-727. [8] Litynski G. Mouret, Dubois an Perissat. The French connection. In: Highlights in the history of laparoscopy Frankfurt: Bernert, 1996. [9] Bora S,Saydam S,Özman İ,Füzün M,Gülay H,Soylu M. Laparoskopik kolesistektominin ilk 6 aylık sonuçları. Klin Den Cer Derg. 1993;1:213-215. [10] Maclntyre P. General principles for laparoscopic surgery. Allman K.G, Wilson I. H.(ed.) Oxford Handbook of Anaesthesia 2002;289-294. [11] Avcı C. Videolaparoskopik kolesistektomi. Kalaycı G ( ed ). Genel Cerrahi, İstanbul, Nobel Tıp Kitapevi. 2002: 763-773. [12] Dion YM, Morin J. Laparoscopic cholecystectomy. A review of 258 patients. Can. J. Of Surgery 1992; 35 (3):317-320. [13] Cunningham AJ, Brull SJ. Laparoscopic cholecystectomy: anesthetic implications. Anesth Analg. 1993;76:1120-1133. [14] Frazee RC, Roberts JW, Okeson GC, et al. Open versus laparoscopic cholecystectomy--a comparison of postoperative pulmonary function. Ann Surg. 1991;213:651-653. [15] Puri GD, Singh H. Ventilatory effects of laparoscopy under general anesthesia. Br J Anesth. 1992;68:211-213. [16] Taskın M, Zengin K. Laparoskopik cerrahinin tarihçesi. Laparoskopik cerrahi. Alemdaroglu K, Taskın M, A [17] Peters JH, Ellison CE. Safety and efficacy of laparoscopic cholecystectomy. Ann Surg 1991;1: 3-12. [18] Rademaker BM, Ringers J, Odoom JA, Dewit LT, Kalkman CJ, Oosting J: Pulmonary function and stres response after laparoscopic cholecystectomy: comparison with subcostal incision and influence of thorasic epidural analgesia. Anesth Analg 1992, 75: 381- 385. [19] Blobner M, Felber AR, Gogler S, et al. Zur Resorption von Kohlendioxid aus dem Pneumoperitoneum bei laparoskopisthen Cholezystektomien. Anaesthesist 1993;42:288-94. [20] Meeks GR. Advanced laparoscopic gynecologic surgery. Surg Clin North Amer 2000:1443-64. [21] Paw P, Sackier JM. Complications of laparoscopy and thoracoscopy. J Intensive Care Med 1994;9:290-304. [22] Sharma KC, Kabinoff G, Ducheine Y, Tierney J, Brandstetter RD. Laparoscopic surgery and its potential for medical complications. Heart Lung 1997;26:52-64. [23] Kehlet H, Rosenberg J, Ottesen BS. Laparoscopic surgery: An update of current status. Ugeskr Laeger 2001;163:757-62. [24] Cunningham AJ. Anesthetic implications of laparoscopic surgery. Yale J Biol Med 1998;71:551-78. [25] Nathanson LK, Shimi S, Cuschieri A. Laparoscopic cholecysectomy: the Dundee tecnique. Br.J. Surgery 1991;78:155-159. [26] Flowers JL, Bailey RW, Scovill WA. et al. The Baltimore experience with laparoscopic management of acut cholecystitis. The American J. of Surgery. 1991;161:388-392 [27] Sharma KC, Brandstetter RD, Brensilver JM, Jung LD. Cardiopulmoner physiolojy and pathophysiology consequence of laparoscopic surgery. Chest 1996;110:810-815. [28] Odeberg S, Ljungqvist O, Svenberg Tluence, et al: Haemodynamic effects of pneumoperitoneum and the influence of posture during anesthesia dor laparoscopic surgery. Acta Anesthesiol Scand 1994; 38:276. [29] Lentschener C, Axler O, Fernandez H, et al: Haemodynamic changes and vazopressin release are not consistently associated with carbon dioxide pneumoperitoneum in humans. Acta Anesthesiol Scand 2001; 45:527. [30] Rosmussen JP, Douchot PJ, De Palma RG, et al. Cardiac function and hipercarbia. Arch Surg 1978;10: 1196-1200. [31] Joris JL, Chiche JD, Canivet JL, et al: Hemodynamic changes during laparoscopic cholecystectomy. Br J Anaesth 1997;78:264. [32] Diebel L, Wilson R, Dulchavsky S, Saxe J. Effect of increased intra-abdominal pressure on hepatic arterial, portal venous and hepatic microcirculatory blood flow. J Trauma 1992;33:279-282. [33] Eric J. K, John T. ., Amira S. Impairment of Cardiac Performance by Laparoscopy in Patients Receiving Positive End-Expiratory Pressure. Arch Surg. 1999;134:76-80. [34] Kraut EJ, Amira S, Ronald B, Bruce MW. Impairment of cardiac performance by laparoscopy in patients receiving positive endexpiratory pressure. Arch Surg. 1990;134(1):76-80. [35] Ulukaya S, Ayanoğlu HÖ, Demir F, Anadol Ö. Laparoskopik kolesistektomi sırasında 5 cmH2O PEEP uygulanmasının solunum mekanikleri ve ölü boşluk ventilasyonu üzerine etkisi. TARK 2000; s:408. [36] Pelosi P, Ravagnan I, Giurati G, Panigada M, Bottino N, Tredici S, Eccher LG, Gattinoni L. Positive end-expiratory pressure improves respiratory function in obese but not in normal subjects during anesthesia and paralysis. Anesthesiology 1999:91:1221-1231. [37] Cunnigham AJ, Brull SJ. Laparoscopic cholecystectomy: Anesthetic implications. Anesth. Analg 1993;76:1120-33. [38] Baraka A, Jabbour S, Hammoud R, Aoud M, Najjar F, Khoury G et al. End-tidal Carbon dioxide tension during laparoscopic cholecystectomy. Anaesthesia 1994:49;304-306. [39] Rauh R, Hemmerling T.M, Rist M., Jacobi K. E. Influence of Pneumoperitoneum and Patient Positioning on Resiratory System Compliance. Journal of Clinical anesthesia 2001;13:361-365. [40] R. L. Marshall, J. R. Jebson, I. T. Davıe. Cırculatory Effects Of Carbon Dıoxıde Insufflatıon Of The Perıtoneal Cavıty For Laparoscopy. British Journal of Anaesthesia, 1972, Vol. 44, No. 7:680-684. [41] Haris SN, Ballantyne GH, Luther MA, Perrino mc. Alterations of cardiovascular performance during laparoscopic colectomy: a combined hemodynamic and echocardiographic analysis. anesth analg 1996;83(3):482-87. [42] Fallot R, Snow M. Cardiopulmonary bedside monitoring. Principles and applications of cardiorespiratory care equipment. Missouri, Mosby İnc.1994:283-331 [43] Köprülü Ş, Esen F, Tütüncü A ve ark. Laparoskopik cerrahinin akciğer mekaniğine etkileri. Türk Anest Rean Cem Mecmuası 1995; 23:427-430. [44] Oikkonen M, Tallgren M. Changes in respiratory compliance at laparoscopy: measurements using side stream spirometry. Can J Anaesth 1995; 42:495-497. [45] Wahba RW, Beique F, Kleiman SJ. Cardiopulmonary function and laparoscopic cholecystectomy. Can J Anaesth 1995; 42:51-63. [46] Hirvonen EA, Nuutinen LS, Kauko M. Ventilatory effects, blood gas changes, and oxygen consumption during laparoscopic hysterectomy. Anesth Analg 1995; 80:961-966. [47] Kendall AP, Bhatt S, Oh TE. Pulmonary consequences of carbon dioxide insufflation for laparoscopic cholecystectomies. Anaesthesia 1995; 50:286-289.