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Objective To compare the different parts of laparoscopic surgery to establish different inflatable lacunar CO2 absorption. Methods 40 patients scheduled for laparoscopic surgery, ASA I-~~ Ⅱ, inflatable lacunar and surgical site is divided into four groups, each 10 cases, Ⅰ group the subcutaneous tissue gap inflatable group (the thyroid adenoma laparoscopic thyroid part resection surgery); Ⅱ group for upper abdominal intraperitoneal laparoscopic surgery (laparoscopic partial hepatectomy); the group Ⅲ lower abdominal intra-abdominal laparoscopic surgery (laparoscopic hysterectomy); Ⅳ group extraperitoneal space inflatable group ( Totally extraperitoneal laparoscopic hernia repair). 40 cases of laparoscopic surgery in the rapid induction of orotracheal intubation, inhalation composite maintain anesthesia, medication type, dose unified. Endotracheal intubation underwent mechanical intermittent positive pressure ventilation (IPPV) set the breathing parameters moisture amount (VT), 10 ml of · kg -1, respiratory frequency (RR) 12 times / min, FiO2 50%, I: E 1: 2. PetCO2 ≥ 50mmHg increase RR to maintain PetCO2 ≤ 50mmHg. Record 10min (after induction and intubation the inflatable ago), inflatable 10min, inflatable in 30min, inflatable in 60min the deflated after 15min, HR, NBP, SpO2, PetCO2, Ppeak, the pH, PaO2, PaCO2, to calculate Pa-etCO2 VCO2 to the patient record whether the occurrence of subcutaneous emphysema and the degree and deflated the time of removal of endotracheal tube. General Information of the four groups of patients (age, weight), SpO2, PaO2 difference not statistically significant (P gt; 0.05). Before the pneumatic inflatable in four groups each group at each time point HR PetCO2, PaCO2, Pa-etCO2 VCO2 were higher the PH were lower (P lt; 0.05) were significantly higher SBP, DBP, MAP inflatable in 10min (P lt; 0.05), groups I Inflatable in 60min and deflated Ppeak elevated (P lt; 0.05), Ⅱ group, Ⅲ group at each time point in the III group inflatable Ppeak were significantly higher (P lt; 0.05); Ⅳ majority of patients deflated 15minPetCO2, PaCO2 group in the inflatable each time point PetCO2 higher than group Ⅱ is higher than the other three groups, the group Ⅲ PaCO2, VCO2, Pa.-etCO2 PH lower than the other three groups (P lt; 0.05); , VCO2 not back to the level before the inflatable. All operations were successfully completed; group II and group III surgery longer than group Ⅰ and Ⅳ group (P lt; 0.05); within each group, patients with varying degrees of subcutaneous emphysema; each group tracheal extubation time was no difference between statistically significant (P gt; 0.05); There are nine cases in 60min PetCO2 ≥ 50mmHg, maintain PetCO2 ≤ 50mmHg by adjusting the RR. Conclusions in different parts of the establishment of different inflatable lacunar laparoscopic surgery the extent of absorption of carbon dioxide, not airtight coverage without serosal peritoneal the outer gap inflatable group of the CO2 absorption than intraperitoneal inflatable group and subcutaneous gap inflatable group; head low aggravate respiratory function inhibition; subcutaneous emphysema and surgery space residual CO2 is CO2 outgassing continue to absorb the main reason; allow hypercapnia body is safe, with the inflatable end, hypercapnia gradually corrected; appropriate The anesthetic management is to ensure the safe completion of laparoscopic surgery.
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