Laparoscopic surgery: A randomised controlled trial comparing intraoperative hemodynamic parameters and arterial-blood gas changes at two different pneumoperitoneal pressure values

Comment on Eva et al. laparoscopic surgery: Ann Med Surg (Lond). 2022 Sep 2;81:104562

“…Further, after deflation, decreased pCO 2 was accompanied by increased pH in this group of patients with a CO 2 pneumoperitoneum pressure of 12 mm Hg. These observations did not correspond to the physiologic balance between pCO 2 and pH 1 .…”

“…From this view, unexpected respiratory rate and pH changes are bizarre and disputable in contrast to their observation concerning pCO 2 dynamics during CO 2 pneumoperitoneum 1 . The pCO 2 dynamics demonstrated increased carbon dioxide concentration during CO 2 pneumoperitoneum with subsequently decreased pCO 2 after deflation in both groups.…”

“…Strangely, the respiratory rate increased enormously after deflation in patients with 12 mm Hg CO 2 pneumoperitoneum pressure, although all disturbances of blood gas parameters in patients with 8 mm Hg pressure were in the frame of dynamic changes for these values during laparoscopic surgery and CO 2 pneumoperitoneum with lung ventilation management 1 .…”

“…Recently, a randomized controlled trial comparing intraoperative hemodynamic parameters and arterial blood gas changes at two different pneumoperitoneum pressure regimens by Eva and colleagues was published in the Annals of Medicine and Surgery 1 .…”

“…In this study, the authors demonstrated changes in hemodynamic, respiratory, blood gas, and acid–base parameters in two groups of patients during laparoscopic surgery with a CO 2 pneumoperitoneum pressures of 8 and 12 mm Hg. Perioperative measurements were performed before and after anesthesia induction, 30 min after the start of the CO 2 pneumoperitoneum, and 5 min after deflation 1 .…”