• J P Estèbe, E Ternisien, J L Polard, A Lenaoures, M Leroy, J L Husson, and C Ecoffey.
• Department of Anaesthesia and Intensive Care, Pain Clinic, University of Rennes, Hôpital Hôtel Dieu, 2 Rue de l'Hôtel Dieu, 35000 Rennes, France. jean-pierre.estebe@chu-rennes.fr
• J Clin Anesth. 2002 Sep 1; 14 (6): 437-40.

Study ObjectiveTo evaluate the effect of carbon dioxide (CO(2)) pneumoperitoneum and retropneumoperitoneum insufflation on CO(2) excretion.DesignProspective study.SettingOperating room and recovery room in a teaching hospital.Patients29 patients scheduled for orthopedic spine fusion surgery.InterventionsPatients received either transperitoneal insufflation (n = 12) or retroperitoneal insufflation (n = 17).Measurements And Main ResultsIncreases in the partial pressure of end-tidal CO(2) (PetCO(2)) and arterial CO(2) tension (PaCO(2)) during retropneumoperitoneum exceeded those obtained during pneumoperitoneum. Furthermore, PetCO(2) increased faster during retroperitoneum and did not reach a plateau. Finally, 76% of the patients in this group required ventilatory adjustment due to high PetCO(2) levels.ConclusionsThis study may focus attention on the need for continuous ventilatory adjustments during transperitoneal endoscopic surgery.

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