Indian Journal of Anaesthesia  
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CLINICAL INVESTIGATION
Year : 2012  |  Volume : 56  |  Issue : 3  |  Page : 276-282

A comparison between volume-controlled ventilation and pressure-controlled ventilation in providing better oxygenation in obese patients undergoing laparoscopic cholecystectomy


1 Department of Anaesthesiology, Institute of Post Graduate Medical Education and Research, Kolkata, India
2 Department of Anaesthesiology, RMO Cum Clinical Tutor Midnapur Medical College, Kolkata, India
3 Department of Anaesthesiology, Calcutta National Medical College, Kolkata, India
4 Department of Anaesthesiology, R. G. Kar Medical College, Kolkata, India
5 Department of Anaesthesiology, Medical College, Kolkata, Kolkata, India
6 Department of Anaesthesiology, Burdwan Medical College, Kolkata, India
7 Post Graduate Student, IPGME and R, Kolkata, India

Correspondence Address:
Sampa Dutta Gupta
Department of Anaesthesiology, 42 Lake Place, 1st Floor, Kolkata 700 029, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5049.98777

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Background: The maintenance of oxygenation is a commonly encountered problem in obese patients undergoing laparoscopic cholecystectomy. There is no specific guideline on the ventilation modes for this group of patients. Although several studies have been performed to determine the optimal ventilatory settings in these patients, the answer is yet to be found. The aim of this study was to evaluate the efficacy of pressure-controlled ventilation (PCV) in comparison with volume-controlled ventilation (VCV) for maintaining oxygenation during laparoscopic cholecystectomy in obese patients. Methods: One hundred and two adult patients of ASA physical status I and II, Body Mass Index of 30-40 kg/m 2 , scheduled for laparoscopic cholecystectomy were included in this prospective randomized open-label parallel group study. To start with, all patients received VCV. Fifteen minutes after creation of pneumoperitoneum, they were randomized to receive either VCV (Group V) or PCV (Group P). The ventilatory parameters were adjusted accordingly to maintain the end-tidal CO 2 between 35 and 40 mmHg. Respiratory rate, tidal volume, minute ventilation and peak airway pressure were noted. Arterial blood gas analyses were done 15 min after creation of pneumoperitoneum and at 20-min intervals thereafter till the end of the surgery. All data were analysed statistically. Results: Patients in Group P showed a statistically significant ( P < 0.05) higher level of PaO 2 and lower value of PAO 2 -PaO 2 than those in Group V. Conclusion: PCV is a more effective mode of ventilation in comparison with VCV regarding oxygenation in obese patients undergoing laparoscopic cholecystectomy.


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