Anaesthesia and intensive care
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Anaesth Intensive Care · Jul 2009
Randomized Controlled TrialEffect of pre-emptive alveolar recruitment strategy before pneumoperitoneum on arterial oxygenation during laparoscopic hysterectomy.
In a randomised, controlled, single-blind trial, we examined the effect of a pre-emptive alveolar recruitment strategy on arterial oxygenation during subsequent pneumoperitoneum. After intubation, 50 patients were randomly allocated to receive either tidal volume 10 ml/kg with no positive end-expiratory pressure (group C) or alveolar recruitment strategy of 10 manual breaths with peak inspiratory pressure of 40 cmH2O plus positive end-expiratory pressure of 15 cmH2O before gas insufflation (group P). ⋯ Alveolar-arterial oxygen gradient in group P increased less after gas insufflation (13 +/- 9 to 60 +/- 34 mmHg vs 10 +/- 9 to 37 +/- 31 mmHg, P = 0.013). We conclude that the alveolar recruitment strategy we applied before insufflation of the peritoneal cavity may improve oxygenation during laparoscopic hysterectomy