Investigation of the effects of CO2 insufflation on blood gas values during laparoscopic procedures in pigs

Authors: ÖZLEM GÜZEL, DİLEK OLĞUN ERDİKMEN, DİDAR AYDIN, ZİHNİ MUTLU, ESMA YILDAR

Abstract: Due to the fact that they produce less post-operative pain and shorter hospitalisation times, laparoscopic surgery procedures are more widely used than many traditional open surgical methods. However, the carbon dioxide gas used to visualise the surgical site during the procedure causes complications such as an increase in the blood CO_2 level and acidosis. In the present study, 12 male pigs were used. Sedation was achieved via intramuscular injection of xylazine at a dose of 2 mg/kg and anaesthesia induction was done via slow intravenous injection of ketamine HCl at a dose of 2 mg/kg. Following endotracheal intubation, general anaesthesia was maintained using isoflurane. Blood samples were collected from the retrobulbar plexus immediately before CO_2 pneumoperitoneum (T_0) and 30 min after insufflation (T_1). Cases were evaluated with respect to pH, pCO_2, HCO-_3, and SpO_2 levels. The findings obtained revealed that there was a statistically significant difference between T0 and T1 measurement times with respect to pCO_2 and HCO-_3 although there were no significant differences between the other evaluated parameters. As a result, it has been demonstrated that carbon dioxide pneumoperitoneum in laparoscopic surgery increases blood CO_2 levels. Careful anaesthesia, endotracheal intubation, and 100% O_2 inhalation throughout anaesthesia, however, can compensate for this increase. Consequently, with the preservation of blood pH and the stabilisation of pO_2 levels, laparoscopic interventions can be performed without endangering the patient's life.

Keywords: Laparoscopy, carbon dioxide, blood gas, pig

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