Changes in Intraoperative Parameters During Laparoscopy with Low Pressure vs Conventional Insufflation
Sebnem Selek1 , Maher Alazizi2, Mohammed Ismail2, Khaled Afifi4, Hari Krovvidi3, Hassan Morsi2, Farshad Tahmasebi2
1Princess Alexandra Hospital NHS Trust, UK
2The Dudley Group NHS Foundation Trust, UK
3University Hospitals Birmingham NHS Foundation Trust, UK
4 Obstetrics & Gynaecology Department, Faculty of Medicine, Ain Shams University, Egypt
OBJECTIVES
-To evaluate the difference in intraoperative parameters during laparoscopy with Airseal® system at 7mmHg (low pressure, LP) insufflation and conventional laparoscopy with 15mmHg (standard) insufflation (SI) in gynaecological surgeries,
-To compare the duration of recovery from general anaesthesia (GA) after LP laparoscopy with duration of recovery from GA following SI laparoscopy.
DESIGN AND METHODS
-Our study is a retrospective observational cohort study.
-Patients who had LP laparoscopy and SI laparoscopy for gynaecological causes at the Dudley Group NHS Foundation Trust over two years were selected retrospectively.
-Exclusion criteria included history of multiple abdominopelvic procedures, severe PID and suspected or confirmed frozen pelvis.
-Data on patient demographics, surgical details and anaesthetic parameters were collected from electronic and paper records.
-Intraoperative parameters which were used for statistical analysis were decided to be Peak Airway Pressure (PAP), Systolic Blood Pressure (SBP), and End Tidal CO2 (EtCO2). Recordings for each parameter at the beginning, in the middle and at the end of the procedure were found. We also included the duration of recovery from GA in our dataset.
-Statistical analysis was performed using GraphPad Prism software (Version 9.0.0). Two-sided alpha level of 0.05 was considered statistically significant.
RESULTS
-77 patients who had laparoscopic surgery for gynaecological causes were identified and selected.
- 41 out of 77 had laparoscopic surgery with 7mmHg Airseal® system and grouped as LP arm.
-36 patients underwent laparoscopy with 15mmHg insufflation and grouped under SI arm.
CONCLUSION
In conclusion, our results show that:
-There is no statistically significant difference in intraoperative parameters between the LP group and SI group, except PAP levels at the end of the procedure and EtCO2 levels mid-procedure.
-The recovery from GA is significantly shorter in the LP group.
