• Shi-Wei Liang, Chun-Shui Lin, Jin-Fang Xiao, and Miao-Ning Gu.
• Department of Anesthesiology, Nanfang Hospital, First Military Medical University, Guangzhou 510515, China.
• Di Yi Jun Yi Da Xue Xue Bao. 2002 Feb 1;22(2):166-7.

ObjectiveTo investigate the effects of intraperitoneal CO2 insufflation on the hemodynamics, oxygen consumption (VO2) and carbon dioxide production (VCO2) during intravenous anesthesia with propofol in combination with epidural block.MethodsIntratracheal intubation was performed after rapid induction of anesthesia and mechanical ventilation was given. Maintenance of anesthesia was achieved using continuous intravenous propofol infusion (2 mg/kg/h) ?N2O inhalation and intermittent epidural administration. Indices of hemodynamics and respiratory function were collected 5 min before induction, 1 min before CO2 insufflation, and 5, 10, 20, 30, 40, 50, 60 min after the start of insufflation and 5 min after the termination of insufflation.ResultsThe mean arterial pressure (MAP), heart rate (HR), end-tidal PCO2 (P(ET)CO2), VO2 and VCO2 1 min before insufflation were markedly reduced(P<0.01), compared with those recorded before induction. MAP and HR did not undergo any conspicuous changes during CO2 insufflation and 5 min after insufflation termination. Compared with that 1 min before insufflation, PETCO2 was significantly increased 20 min after the start of insufflation (P<0.01), and subsequently carried on the increase though of a lesser scale. VO2 and VCO2 gradually rose after the start of insufflation, and VO2 presented a significantly elevation (P<0.01) 10 min after the insufflation while VCO2 did not show this marked increase(P<0.05) till 20 min after the insufflation in comparison with the levels before insufflation. Subsequently, VO2 continued to rise and VCO2 also retained the increase but of smaller magnitude.ConclusionIntravenous propofol anesthesia combined with epidural block assisted by well-managed excessive ventilation before insufflation can alleviate the adverse effects of CO2 insufflation on respiratory and circulatory systems.

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