Azevedo João L M C, Azevedo Otavio C, Sorbello Albino A, Becker Otavio M, Hypolito Otavio, Freire Dalmer, Miyahira Susana, Guedes Afonso, Azevedo Glicia C
Department of Surgery, Federal University of São Paulo, São Paulo, Brazil.
J Laparoendosc Adv Surg Tech A. 2009 Dec;19(6):731-4. doi: 10.1089/lap.2009.0080.
The aim of this work was to establish reliable parameters of the correct position of the Veress needle in the peritoneal cavity during creation of pneumoperitoneum.
The Veress needle was inserted into the peritoneal cavity of 100 selected patients, and a carbon-dioxide flow rate of 1.2 L/min and a maximum pressure of 12 mm Hg were established. Intraperitoneal pressure (IP) and the volume of gas injected (VG) were recorded at the beginning of insufflation and at every 20 seconds. Correlations were established for pressure and volume in function of time. Values of IP and VG were predicted at 1, 2, 3, and 4 minutes of insufflation, by applying the following formulas: IP = 2.3083 + 0.0266 x time +8.3 x 10(-5) x time(2) - 2.44 x 10(-7) x time(3); and VG = 0.813 + 0.0157 x time.
A strong correlation was observed between IP and preestablished time points during creation of the pneumoperitoneum, as well as between VG and preestablished time points during creation of the pneumoperitoneum, with a coefficient of determination of 0.8011 for IP and of 0.9604 for VG. The predicted values were as follows: 1 minute = 4.15; 2 minutes = 6.27; 3 minutes = 8.36; and 4 minutes = 10.10 for IP (mm Hg); and 1 minute = 1.12; 2 minutes = 2.07; 3 minutes = 3.01; and 4 minutes = 3.95 for VG (L).
Values of IP and VG at given time points during insufflation for creation of the pneumoperitoneum, using the Veress needle, can be effective parameters to determine whether the needle is correctly positioned in the peritoneal cavity.
本研究旨在确定在建立气腹过程中Veress针在腹腔内正确位置的可靠参数。
将Veress针插入100例选定患者的腹腔，设定二氧化碳流速为1.2L/min，最大压力为12mmHg。在充气开始时及每20秒记录一次腹腔内压力（IP）和注入气体量（VG）。建立压力和体积随时间变化的相关性。通过应用以下公式预测充气1、2、3和4分钟时的IP和VG值：IP = 2.3083 + 0.0266×时间 + 8.3×10⁻⁵×时间² - 2.44×10⁻⁷×时间³；VG = 0.813 + 0.0157×时间。
在建立气腹过程中，观察到IP与预设时间点之间以及VG与预设时间点之间存在强相关性，IP的决定系数为0.8011，VG的决定系数为0.9604。预测值如下：IP（mmHg）：1分钟 = 4.15；2分钟 = 6.27；3分钟 = 8.36；4分钟 = 10.10；VG（L）：1分钟 = 1.12；2分钟 = 2.07；3分钟 = 3.01；4分钟 = 3.95。
使用Veress针建立气腹时，在给定时间点的IP和VG值可作为确定针是否正确置于腹腔内的有效参数。
