Pan Xin, Wang Dan
Xin Pan Department of Anesthesiology, Affiliated Hospital of Xuzhou Medical College, Xuzhou, Jiangsu Province 221000, P.R. China.
Dan Wang Department of Anesthesiology, Xuzhou Hospital of Traditional Chinese Medicine, Xuzhou, Jiangsu Province 221000, P.R. China.
Pak J Med Sci. 2025 Mar;41(3):719-723. doi: 10.12669/pjms.41.3.11348.
To investigate the effect of different levels of positive end-expiratory pressure (PEEP) in patients undergoing laparoscopic cholecystectomy under general anesthesia.
This retrospective study included patients who underwent laparoscopic cholecystectomy under general anesthesia in the Xuzhou Hospital of Traditional Chinese Medicine from January, 2023 to March, 2024. Based on the PEEP levels, patients were grouped into 0cm group (0cmHO), 5cm group (5cmHO), 8cm group (8cmHO), and 10cm group (10cmHO). Mean arterial pressure (MAP), mean airway pressure (P), peak airway pressure (P), and blood gas status levels (oxygenation index[OI], arterial partial pressure of oxygen [PaO], and arterial partial pressure of carbon dioxide [PaCO]) of all four groups were measured at five minutes after the intubation (T1), five minutes after pneumoperitoneum (T2), and 30 minutes after pneumoperitoneum (T3).
A total of 84 patients (37 males and 47 females) were included in this study. The number of patients in the 0cm group, 5cm group, 8cm group, and 10cm group were 24, 24, 21, and 15, respectively, and there were no significant differences in the baseline data among the four groups. There were significant differences in P, P, and MAP between the four groups at T2 and T3. The increase in PEEP was accompanied by a gradual increase in P and P (<0.05). There were significant differences in OI, PaCO, and PaO among the four groups at T2 and T3. With the increase in PEEP, OI and PaO values continued to increase while PaCO continued to decrease (<0.05).
During laparoscopic cholecystectomy under general anesthesia, PEEP = 5cmHO can inhibit a significant decrease in MAP while ensuring the patient's blood gas and respiratory mechanics status, which can ensure hemodynamic stability.
探讨全身麻醉下腹腔镜胆囊切除术患者不同水平呼气末正压（PEEP）的效果。
这项回顾性研究纳入了2023年1月至2024年3月在徐州市中医院接受全身麻醉下腹腔镜胆囊切除术的患者。根据PEEP水平，将患者分为0cm组（0cmHO）、5cm组（5cmHO）、8cm组（8cmHO）和10cm组（10cmHO）。在插管后5分钟（T1）、气腹后5分钟（T2）和气腹后30分钟（T3）测量四组患者的平均动脉压（MAP）、平均气道压（P）、气道峰压（P）和血气状态水平（氧合指数[OI]、动脉血氧分压[PaO]和动脉血二氧化碳分压[PaCO]）。
本研究共纳入84例患者（男37例，女47例）。0cm组、5cm组、8cm组和10cm组的患者人数分别为24例、24例、21例和15例，四组患者的基线数据无显著差异。四组患者在T2和T3时的P、P和MAP存在显著差异。PEEP的增加伴随着P和P的逐渐升高（<0.05）。四组患者在T2和T3时的OI、PaCO和PaO存在显著差异。随着PEEP的增加，OI和PaO值持续升高，而PaCO持续降低（<0.05）。
在全身麻醉下腹腔镜胆囊切除术中，PEEP = 5cmHO可在确保患者血气和呼吸力学状态的同时抑制MAP的显著下降，从而确保血流动力学稳定。
