J.Jpn. Surg. Soc.. 95(5): 336-342, 1994

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Original article

CHANGES OF ARTERIAL CO₂（PaCO₂）AND URINE OUTPUT BY CARBON DIOXIDE INSUFFLATION OF THE PERITONEAL CAVITY DURING LAPAROSCOPIC CHOLECYSTECTOMY

We studied on the effects of carbon dioxide insufflation during laparoscopic cholecystectomy on the arterial blood gas analysis and urine output. Intra-abdominal pressure was increased up to either 10cmH₂O or 15cmH₂O, and we compared the PaCO₂ values before and during insuMation. Both increase of PaCO₂ and decrease in pH were larger in intra-abdominal pressure of 15cmH₂O than 10cmH₂O. In the intra･abdoninal pressure 15cmH₂O group, the increase of PaCO₂ by CO₂ periotoneal insufflation was significantly larger in operative time of more than 60 minutes group than in less than 60 minutes group, but no significant changes were observed in 10cmH₂O group. In the group of obesity index of more than 120, elevation levels of PaCO₂ by CO₂ insuMation were significant, but in the group of less than 120 no significant elevation were observed. The tendancy that the urine output during operation was decreased as increase of intra-abdominal pressure or operative time, but the obesity had no definite effects on urine output. InsuMation of the abdomen with CO₂ caused large changes in PaCO₂ or pH in the patients with a previous history of major cardiopulmonary disorder. It was shown that the low insuraation pressure and short operative time is good for the maintenance of normal physiological state.

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