Comparison and Evaluation of the Effects of Administration of Postoperative Non-Invasive Mechanical Ventilation Methods (CPAP and BIPAP) on Respiratory Mechanics and Gas Exchange in Patients Undergoing Abdominal Surgery

Objective: The aim of our study is to investigate the effect of two different methods of continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BIPAP) and oxygen support under spontaneous ventilation on respiration mechanics, gas exchange, dry mouth and face mask lesion during an early postoperative period in patients undergoing upper abdominal surgery

Comparison and Evaluation of the Effects of Administration of Postoperative Non-Invasive Mechanical Ventilation Methods (CPAP and BIPAP) on Respiratory Mechanics and Gas Exchange in Patients Undergoing Abdominal Surgery

OBJECTIVE: The aim of our study is to investigate the effect of two different methods of continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BIPAP) and oxygen support under spontaneous ventilation on respiration mechanics, gas exchange, dry mouth and face mask lesion during an early postoperative period in patients undergoing upper abdominal surgery. METHODS: Eighty patients undergoing elective abdominal surgery with laparotomy, between the age of 25 and 75 years and American Society of Anesthesiologists Physical Status score (ASA) II–III with chronic obstructive pulmonary disease (COPD) diagnosis were included to the study. Subjects were randomly allocated in to four groups. During the first postoperative hour, the first group received BIPAP, second group received high-flow CPAP, third group received low-flow CPAP and fourth group received deep breathing exercises, respiratory physiotherapy and O(2) therapy. Preoperative, postoperative before and after treatment PaO(2), PaCO(2), SpO(2), tidal volume (TV), respiratory rate (RR) levels were recorded. Subjects with dry mouth or face mask lesion were recorded. RESULTS: In all groups, PaO(2) and TV measurements were higher at the postoperative first hour than the postoperative zero hour. We found that low-flow CPAP increased PaO(2) and SpO(2) values more, and TV levels were higher in the postoperative period than the preoperative period. PaCO(2) levels were elevated at the zero hour postoperatively and at the end of the first hour; they decreased approximately to preoperative values, except in the fourth group. CONCLUSION: Administration of prophylactic respiratory support can prevent the deterioration of pulmonary functions and hypoxia in patients with COPD undergoing upper abdominal surgery. In addition, we found that low-flow CPAP had better effects on PaO(2), SpO(2), TV compared to other techniques

Restoration of pulmonary compliance after laparoscopic surgery using a simple alveolar recruitment maneuver

Study Objective: To test the hypothesis that a pulmonary maneuver designed to recruit additional alveoli (thereby decreasing atelectasis) applied before extubation can restore pulmonary compliance to baseline values

Evaluation of the Analgesic Efficacy of Dexketoprofen and Tramadol in Thyroid Surgery

Aim: The aim of this study was to evaluate the analgesic efficacy and side-effects of dexketoprofen and tramadol administered intravenously before thyroid surgery. Methods: A group of 63 patients, who were graded as American Society of Anaesthesiologists physical status (ASA) I-II and in whom a thyroid surgery was planned, were randomly divided into 3 groups: the patients in Group D (n=21), Group T (n=21) and Group K (n=21) received 50 mg (2ml) of dexketoprofen, 100 mg (2 ml) of tramadol and 2 ml 0.9% NaCl serum, respectively, before surgery. Standard anesthesia monitoring, induction and maintenance was performed in all patients. At the end of the surgery, the incision line was infiltrated with bupivacaine in all patients. Visual analogue scale (VAS) scores (0: no pain,10: worst pain ever) were recorded in all groups at the beginning (in the recovery room), at the 1st, 6th, 12th and 24th hour post-operatively. Nausea-vomiting, head and neck pain, sore throat, dizziness and other possible side-effects were also asked and recorded. Results: VAS scores were statistically higher in Group K than in Group T and Group D at the 1st, 6th, 12th, and 24th hours postoperatively. There was no significant difference between Group T and Group D in VAS scores evaluated at all time points.. The fentanyl consumption in Group K was higher than in the other two groups. The incidence of headache, sore throat nausea, vomiting was higher in Group K compared with that in Group T and Group D. Conclusion: We determined that preoperative tramadol and dexketoprofen had similar analgesic effect and dexketoprofen caused less side-effects. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52: 5-9