8 research outputs found
Changes in breathing control and mechanics after laparoscopic vs open cholecystectomy
Hypothesis: We hypothesized that there might be different effects on
breathing control and respiratory mechanics after laparoscopic vs open
cholecystectomy.
Design: Randomized clinical trial. Settings:
A general hospital in Greece.
Patients: Of 53 patients assessed for eligibility, 18 and 10 were
randomly allocated to the laparoscopic and open cholecystectomy groups,
respectively. These 28 patients had normal spirometry measurements and
American Society of Anesthesiologists’ class I physical status.
Main Outcome Measures: Measurements of breathing control and mechanics
variables. Tidal volume, inspiratory time, breathing frequency, mean
inspiratory flow, duty cycle, central respiratory drive, and mean
inspiratory impedance were recorded before surgery on the second and
eighth postoperative days. Airway resistance was recorded before surgery
and on the eighth post-operative day, with all measurements being
performed under no influence of analgesia.
Results: Two days after surgery, inspiratory time, breathing frequency,
and central respiratory drive were significantly changed compared with
preoperative values for both methods, whereas mean inspiratory impedance
was significantly increased (P<.001) for the laparoscopic procedure.
Eight days after surgery, changes were seen only for the laparoscopic
group: duty cycle and airway resistance were significantly reduced
(P=.01) and increased (P=.04), respectively, compared with preoperative
data.
Conclusion: Laparoscopic cholecystectomy seems to be associated with
small but sustained alterations in the control of breathing and
mechanics, which might have an unfavorable clinical impact on patients
with compromised lung function