PULMONARY CONSEQUENCES OF CARBON-DIOXIDE INSUFFLATION FOR LAPAROSCOPIC CHOLECYSTECTOMIES

Twenty patients having laparoscopic cholecystectomies were studied for changes in thoracic and lung compliance at 5, 10 and 15 mmHg of intra-abdominal pressure. Fifteen mmHg of intra-abdominal pressure decreased the thoracic and the lung static compliance by 49 and 39% respectively. This was unaffected by the degree of head elevation. During the procedure the end-tidal carbon dioxide increased by a mean of 1.6 kPa at 1 h and 2.0 kPa at 2 h. This did not appear to be related to either the mean intra-abdominal pressure or the total volume of carbon dioxide insufflated. The physiological changes and implications for anaesthetic practice are considered.