CHANGES IN RESPIRATORY COMPLIANCE AT LAPAROSCOPY - MEASUREMENTS USING SIDE STREAM SPIROMETRY

In order to quantify changes in total respiratory compliance (C-rs) effected by peritoneal pressurization we measured, under standardized anaesthetic conditions and using side stream spirometry C-rs in 32 patients scheduled for abdominal surgery through laparoscopic techniques. To qualify the changes in C-rs as to the type (duration anti patient's position) of surgery, 20 patients having cholecystectomy, eight having gastric fundoplication, and four having inguinal hernia repair were studied At CO2 insufflation to a mean intraabdominal pressure of II cmH(2)O in the horizontalposition, C-rs decreased abruptly by 20% in each of the surgical sub-groups (P < 0.05-0.01). During the insufflation period a further deterioration was observed, most pronounced in inguinal hernia patients operated upon in a head-down tilt position (P < 0.05). In the cholecystectomy and fundoplication patients, operated upon in a head-up tilt, the recovery of C-rs was immediate at deflation whereas an incomplete recovery (P < 0.05 vs initial values) was seen in the hernia patients. In evaluating all patients none of the demographic factors, age, sex, body-mars-index, intraabdominal pressure, or duration of pressurization, were associated with the detected changes.