Vegfors M, Engborg L, Gupta A, Lennmarken C
Department of Anesthesiology, University Hospital, Linköping, Sweden.
J Clin Anesth. 1994 May-Jun;6(3):199-203. doi: 10.1016/0952-8180(94)90059-0.
To study the changes in PETCO2 during spontaneous and controlled ventilation in patients undergoing gynecologic laparoscopy.
Randomized, unblinded study.
Department of Gynecology, University Hospital, Linköping, Sweden; Central Hospital, Norrköping, Sweden.
Forty healthy patients undergoing gynecologic laparoscopy.
Patients were divided into 4 groups: Group 1 breathed spontaneously via an endotracheal tube, while the other three groups underwent controlled ventilation to an initial PETCO2 of 3 kPa (22 mmHg) (Group 2), 4 kPa (30 mmHg) (Group 3), or 5 kPa (37 mmHg) (Group 4).
PETCO2 levels were measured at fixed time intervals. Arterial blood gas analyses were done to compare the difference between PETCO2 and PaCO2. In Group 1, PETCO2 increased soon after insufflation and remained above 6 kPa (44 mmHg) throughout the procedure. In Groups 2, 3, and 4, PETCO2 also rose after insufflation, and an initial PETCO2 of 4 kPa (30 mmHg) was ideal, as all PETCO2 values were less than 5.5 kPa (41 mmHg). Occasional episodes of arrhythmia were seen in Group 1. However, no major adverse effects were observed in any of the groups.
In view of the high PETCO2 levels, spontaneous breathing should be avoided during gynecologic laparoscopy, and ventilation to an initial PETCO2 of 4 kPa (30 mmHg) is recommended during controlled ventilation.
研究妇科腹腔镜手术患者在自主呼吸和控制通气期间呼气末二氧化碳分压（PETCO2）的变化。
随机、非盲研究。
瑞典林雪平大学医院妇科；瑞典诺尔雪平中央医院。
40例接受妇科腹腔镜手术的健康患者。
患者分为4组：第1组通过气管插管自主呼吸，而其他三组进行控制通气，使初始PETCO2达到3 kPa（22 mmHg）（第2组）、4 kPa（30 mmHg）（第3组）或5 kPa（37 mmHg）（第4组）。
在固定时间间隔测量PETCO2水平。进行动脉血气分析以比较PETCO2和动脉血二氧化碳分压（PaCO2）之间的差异。在第1组中，气腹后PETCO2迅速升高，并在整个手术过程中保持在6 kPa（44 mmHg）以上。在第2组、第3组和第4组中，气腹后PETCO2也升高，初始PETCO2为4 kPa（30 mmHg）是理想的，因为所有PETCO2值均小于5.5 kPa（41 mmHg）。第1组偶尔出现心律失常。然而，任何一组均未观察到重大不良反应。
鉴于PETCO2水平较高，妇科腹腔镜手术期间应避免自主呼吸，控制通气期间建议将初始PETCO2通气至4 kPa（30 mmHg）。
