Influence of artificial pneumoperitoneum and head down position on patients with lower abdomen laparoscopic surgery

Chen Xueli; Liu Donghua

doi:10.3969/j.issn.1006-7256.2016.10.007

Abstract：Objective:To explore the influence of artificial pneumoperitoneum and head down position on patients with lower abdomen laparoscopic surgery. Methods:Philips Mp50 monitor was used to continuously monitor the heart rate(HR),electrocardiogram(ECG), systolic blood pressure(SBP)and diastolic blood pressure(DBP)of 52 patients with ASA(grade I and II)lower abdomen laparoscopic surgery;Drager Tiro anesthesia machine was used to monitor Comp,Raw,Ppeak and PET CO2 during general anesthesia;the parameter val-ues and IOP were recorded at the 5 time points. Results:The comparison of HR,SBP,DBP was not statistically significant at any time point;the Ppeak,Raw,PET CO2 and IOP value was significantly increased at T1 time point compared with the value at T0 time point;the val-ue at T2 and T3 time points further increased compared with the value at T1 time point(P < 0. 05);IOP at T4 time point reached the peak and decreased significantly compared with that T5 time point in horizontal position(P < 0. 05);Comp decreased at T1 ,T2 ,T3 ,and T4 time points and had the statistically significant difference compared with that at T0 time point(P <0. 05). Conclusion:The artificial pneumoperito-neum and head down position can lead to the significant increase of Ppeak,Raw,PET CO2 and IOP laparoscopic operation,and there is the risk of hypercapnia and visual impairment. Nurses should do predictive nursing care and closely observe the oxygen partial pressure and PET CO2 .