A Comparison of the Effects of Postoperative CPAP and Nasal Oxygen Use on Arterial Blood Gas in Laparoscopic Cholecystectomy Performed in Obese Patients: A Prospective, Randomized Cinical Trial

作者：Kiziloz Sema Peker; Tavlan Aybars; Topal Ahmet^*; Erol Atilla; Kilicaslan Alper; Otelcioglu Seref

来源：Turkiye Klinikleri Tip Bilimleri Dergisi, 2012, 32(3): 726-732.

DOI：10.5336/medsci.2011-25901

• Anesthesia, general
• cholecystectomy, laparoscopic
• blood gas analysis
• continuous positive airway pressure

Objective: This study was designed to compare the effects of continuous positive airway pressure (CPAP) and nasal oxygen use on postoperative blood gases in obese patients undergoing laparoscopic cholecystectomy. Material and Methods: A total of 40 patients with a body mass index (BMI) ranging between 30 and 40 were enrolled in this study. Patients were divided into two groups: Group C (n=20) = CPAP and Group N (n=20) = Nasal O-2. Baseline blood gas was sampled on spontaneous respiration (G(0)). The blood gas sampling was repeated before patients were admitted to the postoperative care unit (PACU) (G(1)). Following the operation, Group C received CPAP 5 cmH(2)O and Group N received 5 1/min O-2 via nasal cannula for 60 minutes. Blood gas sampling was repeated after 60 minutes in both groups (G(2)). Results: At the PACU, the SpO(2) values were higher in Group C relative to Group N at 30 minutes (p<0.05). In both groups, the in-group pH values at G(1) measurement time displayed a statistically significant reduction compared to those at the G(0) measurement time (p<0.05). At G(2), PaCO2 was higher in Group N compared to Group C (p<0.05). In both groups, the in-group PaCO2 values were significantly higher at G(1) relative to G(0) (p<0.01). In Group C, PaO2 was higher at G(2) compared to Group N (p<0.05). Conclusion: Postoperative CPAP use may increase the PaO2 more and provide a better CO2 elimination compared to nasal oxygen use in obese patients undergoing laparoscopic cholecystectomy.

• 出版日期2012-6