Application of PRVC in laparoscopic surgery

Abstract

Objective: To discuss the clinical significance and value of PRVC by monitoring, comparing and studying pressure control (PC), volume control (VC) and pressure-regulated volume control (PRVC) ventilation modes during pneumoperitoneum.

Methods: Ninety patients with laparoscopic cholecystectomy were randomly and equally divided into 3 groups (PC group, VC group and PRVC group). Esophageal pressure (PES), mean airway pressure (PAWM), peak airway pressure (PAP), arterial blood carbon dioxide partial pressure (PaCO₂), end-tidal carbon dioxide concentration in the expired air (ETCO₂), tidal volume (TV), mean arterial pressure (MAP) and heart rate (HR) were not only detected before pneumoperitoneum, but also in 5, 10, 15 and 20 minutes after pneumoperitoneum.

Results: PES after pneumoperitoneum in VC mode was obviously higher than that in PC and PRVC groups. In 10 minutes after pneumoperitoneum, levels of PaCO₂ and ETCO₂ became increased obviously in PC and VC groups (p < .05); levels of PaCO₂ and ETCO₂ were not only increased in PC group, but also the level of TV after pneumoperitoneum in PC group was significantly lower than that in the other two groups (p < .05). Levels of PaCO₂ and ETCO₂ were increased in PC and VC groups after pneumoperitoneum, along with the increase of MAP and HR (p < .05). After pneumoperitoneum, levels of MAP and HR in PRVC group were significantly lower than those in PC and VC groups (p < .05).

Conclusions: PRVC mode can effectively reduce the pneumoperitoneum-induced increase of PAWM, PAP and PES without the unusual increase of PaCO₂ and ETCO₂ during surgery, so as to guarantee the stability of vital signs in perioperative patients.