Hypercapnia during transperitoneal and retroperitoneal endoscopic spinal surgery: A prospective study

• Published in: Journal of clinical anesthesia Vol. 14; no. 6; pp. 437 - 440
• Main Authors: Estèbe, J.P, Ternisien, E, Polard, J.L, Lenaoures, A, Leroy, M, Husson, J.L, Ecoffey, C
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-09-2002; Elsevier Science
• Subjects: Acidosis, Respiratory - etiology; Anesthesia; Anesthesia depending on type of surgery; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Carbon dioxide; Carbon Dioxide - administration & dosage; Carbon Dioxide - blood; Carbon Dioxide - physiology; Endoscopy; Humans; Hypercapnia - etiology; Intraoperative Complications - etiology; Lumbar Vertebrae - surgery; Medical sciences; Orthopedic surgery. Maxillofacial surgery. Otorhinolaryngologic surgery. Stomatology. Ophtalmology. Investigation and treatment technics; Pneumoperitoneum, Artificial - adverse effects; Prospective Studies; Respiration; retroperitoneal; Retroperitoneal Space; Sacrum - surgery; Spinal Fusion; transperitoneal; endoscopy; retroperitoneal; Carbon dioxide; transperitoneal; Endoscopic surgery; Blood gas; PaCO2; Respiratory disease; Spine; Diseases of the osteoarticular system; General anesthesia; Spine disease; Expired gas; Hypercapnia; Artificial pneumoperitoneum; Orthopedic surgery; Partial pressure; Surgery; Arthrodesis; Complication; Surgical approach; Comparative study
• ISSN: 0952-8180; 1873-4529
• DOI: 10.1016/S0952-8180(02)00393-8

To evaluate the effect of carbon dioxide (CO
2
) pneumoperitoneum and retropneumoperitoneum insufflation on CO
2
excretion.
Prospective study.
Operating room and recovery room in a teaching hospital.
29 patients scheduled for orthopedic spine fusion surgery.
Patients received either transperitoneal insufflation (n = 12) or retroperitoneal insufflation (n = 17).
Increases in the partial pressure of end-tidal CO
2
(PetCO
2
) and arterial CO
2
tension (PaCO
2
) during retropneumoperitoneum exceeded those obtained during pneumoperitoneum. Furthermore, PetCO
2
increased faster during retroperitoneum and did not reach a plateau. Finally, 76% of the patients in this group required ventilatory adjustment due to high PetCO
2
levels.
This study may focus attention on the need for continuous ventilatory adjustments during transperitoneal endoscopic surgery.