Background: Managing ventilation and oxygenation during laparoscopic bariatric procedures in morbidly obese patients represents many challenges.
Aim of the Work: To compare the effect of these modes of ventilation on respiratory parameters in obese patients undergoing laparoscopic bariatric surgeries and whether this influences the need of postoperative ventilation or not
Patients and Methods: After approval of ethical committee of faculty of Medicine Ain Shams University and obtaining an informed consent from every patient, this randomized controlled clinical trial study was conducted at Ain Shams University Hospitals operating theatre department on 40 obese adult patients of ASA physical status I - II, admitted to Ain Shams university hospital, scheduled for elective laparoscopic bariatric surgery. General anesthesia with endotracheal intubation and controlled ventilation was conducted in all patients. Patients were divided randomly into two equal groups: Group A; received volume controlled ventilation and Group B; received pressure controlled ventilation.
Results: The study found no significant difference between the two groups as regards PaO2 and PaO2:FiO2 preoperatively, after pneumoperitonium, at the end of surgery and postoperatively. As regards PaCO2 there was no statistically significant difference between the two groups in the preoperative measurement while there was statistically highly significant difference between the two groups after pneumoperitonium, at the end of surgery and postoperatively with lower PaCO2 in group (B) that received PCV than group (A) that received VCV. There was statistically highly significant difference between the two groups as regards dynamic compliance after intubation, after pneumoperitonium and at the end of the surgery with higher dynamic compliance in group (B) that received PCV. The results showed no statistically significant difference between the two studied groups regarding the need of post-operative ventilation.
Conclusion: No significant difference between pressure controlled ventilation and volume controlled ventilation regarding oxygenation and the need of postoperative ventilation but PaCo2 levels are lower and dynamic compliance is higher with pressure controlled ventilation.