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CLINICAL INVESTIGATION
Year : 2008  |  Volume : 52  |  Issue : 2  |  Page : 185-190

Management of Postoperative Hypoxaemia in Patients Following Upper Abdominal Laparoscopic Surgery. - A Comparative Study


1 Assistant Professor, Department Of Anaesthesiology, I.P.G.M.E. & R., Kolkata, 244, Acharyya Jagadish Chandra Bose Road, Kolkata 700020, India
2 P.G.Student, Department Of Anaesthesiology, I.P.G.M.E. & R., Kolkata, 244, Acharyya Jagadish Chandra Bose Road, Kolkata 700020, India
3 Clinical Tutor, Department Of Anaesthesiology, I.P.G.M.E. & R., Kolkata, 244, Acharyya Jagadish Chandra Bose Road, Kolkata 700020, India
4 Associate Professor, Department Of Anaesthesiology, I.P.G.M.E. & R., Kolkata, 244, Acharyya Jagadish Chandra Bose Road, Kolkata 700020, India
5 Professor, Department Of Anaesthesiology, I.P.G.M.E. & R., Kolkata, 244, Acharyya Jagadish Chandra Bose Road, Kolkata 700020, India

Correspondence Address:
Sampa Datta Gupta
42 Lake Place. 1st floor. Kolkata 700029
India
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Source of Support: None, Conflict of Interest: None


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Noninvasive ventilation has been shown to reduce acute postoperative hypoxaemia, with significant reduction in the incidence of re-intubation, complications and a trend towards lower mortality. The aim of the study was to determine the effectiveness of CPAP vs venturi therapy in early achievement of oxygenation goals and in prevention of re-intubation for management of postoperative hypoxaemia following laparoscopic cholecystectomy. Forty adult patients of ASA physical status I& II, scheduled for elective laparoscopic cholecystectomy, those were unable to maintain SpO2 > 95% breathing room air after extubation, were recruited for a prospective, randomized comparative study. Patients with PaO2 / FiO2 between 250 and 300 were included in the study and were randomly allocated to one of the two groups to receive oxygen therapy either using a CPAP of 10 cm of water and a FiO2 of 0.5 (Group A) or using a venturi mask of FiO2 of 0.5 (Group B) . All patients were observed postoperatively upto 18 h and were screened by ABG analyses at 6, 12 and 18 h of treatment. SpO2, ECG, heart rate, respiratory rate, temperature and NIBP were monitored throughout the study period. Patients in Group A showed significant improvement in early achievement of adequate oxygenation than those in Group B, although, due to intolerance to CPAP therapy two patients in Group A needed reintubation to maintain adequate oxygenation. To conclude, oxygenation using continuous positive airway pressure is a safe and effective means in improving gas exchange to treat acute postoperative hypoxaemia in conscious and cooperative patients.


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