Single minute of positive end-expiratory pressure at the time of induction: Effect on arterial blood gases and hemodynamics in morbidly obese patients undergoing laparoscopic bariatric surgery

Abstract

Background:The effect of positive end-expiratory pressure (PEEP) has been studied in detail after induction of general anesthesia especially in obese individuals. However, sparse information can be gathered from the literature regarding its effect when applied at the time of induction and the time of onset of its effect. Thus, this study was planned to assess the effect of PEEP when applied for a single minute in morbidly obese patients.Materials and Methods:This was a randomized prospective study comprising seven morbidly obese patients (body mass index ≥40 kg/m2). Control group included 30 patients who received no PEEP at the time of induction. The study group consisted of thirty patients who were given a PEEP of 10 cmH2O. Serial arterial blood gas samples were taken preoperatively, at the time of intubation, 5 min after intubation and 10 min after intubation.Results:PaO2 was significantly higher in test group (242.0 ± 116.0 mmHg) than in control group (183.0 ± 107.0 mmHg) just after intubation. PaCO2 was comparable in control group (43.73 ± 6.32 mmHg) and test group (44.52 ± 6.33 mmHg) just after intubation but was significantly less in test group than in control group at 5 and 10 min thereafter. Hemodynamic parameters were comparable in both groups at all time intervals.Conclusion:Application of even a single minute of PEEP at the time of induction improves oxygenation without any adverse effects on hemodynamics, in morbidly obese patients undergoing laparoscopic Bariatric surgery.

The effect of low flow anesthesia on hemodynamic and peripheral oxygenation parameters in obesity surgery

“…7 Also, there are studies where low-flow anesthesia in laparoscopic surgery resulted in successful outcomes in addition to balanced oxygen delivery consumption. 8,9 Although limited, there are studies reporting use of low-flow anesthesia in bariatric surgery. [9][10][11] This paper aims to examine the effects of low-flow anesthesia on arterial blood gas, hemodynamic parameters, and anesthesia recovery in patients with morbid obesity who underwent laparoscopic sleeve gastrectomy.…”

“…7 Also, there are studies where low-flow anesthesia in laparoscopic surgery resulted in successful outcomes in addition to balanced oxygen delivery consumption. 8 , 9 Although limited, there are studies reporting use of low-flow anesthesia in bariatric surgery. 9 - 11 …”

“… 8 , 9 Although limited, there are studies reporting use of low-flow anesthesia in bariatric surgery. 9 - 11 …”