Effects of Positive End Expiratory pressure during laryngeal mask airway anesthesia on respiratory parameters and abdominal pain

Abstract

The majority of patients undergoing ophtalmic surgery have underlying cardiovascular diseases due to old age, and because gastric insufflation is one of the complications seen in recovery, in this study we tried to compare two types of ventilation methods. Volume-controlled ventilation with and without PEEP during anesthesia with laryngeal mask airway, the most appropriate method in terms of various ventilation parameters and the abdominal pain should be compared and evaluated. Methods: In this study, 80 patients who underwent cataract surgery were randomly entered into the study in terms of inclusion and exclusion criteria and also after obtaining informed consent, and were divided into two groups of 40 and examined. Factors such as the type of anesthesia machine, ventilator settings and the type of laryngeal mask airway used are considered as possible confounding factors, and by standardizing these cases, an attempt was made to neutralize their possible effects. For the first group, volume-controlled ventilation without PEEP, with tidal volume of 6 ml/kg based on the ideal body weight, was started with a respiratory rate of 8-10 per minute. In the second group, exactly the same as the first group and PEEP was applied at a rate of 5 cmH2o. At intervals of 1, 5, 10 and 20 minutes after the start of anesthesia, the parameters of peak pressure (PPeak), dynamic compliance, expiratory flow volume, Spo2 (pulse oximetry), non-invasive blood pressure and heart rate for all patients were recorded by an anesthesiologist. After the patient became conscious enough to be able to talk, he or she was asked about pain in the epigastrium and around the umblicus. Recorded for the patient by an anesthesiologist other than the anesthetist.

Results: In this study, there was no statistically significant difference between the two groups in comparing gender, mean age, weight, height and BMI. There was no statistically significant difference between the mean groups of Ppeak and Dynamic Compliance between the two groups in the first minute, fifth minute, tenth minute and twentieth minute. There was no statistically significant difference between the mean SpO2, EtCo2, systolic blood pressure, diastolic blood pressure and heart rate of the two groups in the first minute and the fifth minute, tenth and twentieth minute. Comparing the pain of the two groups in the group without PEEP (90%) 36 people did not have pain and (10%) 4 people had pain, in the group with PEEP (100%) 40 people did not have pain, which There was no statistically significant difference between the two groups.