Comparison of Transcutaneous, Arterial and End-tidal Measurements of Carbon Dioxide during Laparoscopic Cholecystectomy in Patients with Chronic Obstructive Pulmonary Disease

OBJECTIVE: Transcutaneous, arterial and end-tidal measurements of carbon dioxide were compared in patients (American Society of Anesthesiology physical status classes II and III) with chronic obstructive pulmonary disease (COPD) who underwent laparoscopic cholecystectomy with carbon dioxide insufflation. METHODS: General anaesthesia was performed in all patients. The Sentec (R) system was used for transcutaneous monitoring of the partial pressure of carbon dioxide (TcPco(2)). TcPco(2) and arterial partial pressure of carbon dioxide (Paco(2)) were recorded preoperatively, after induction of anaesthesia, during insufflation and postoperatively; end-tidal carbon dioxide (ETco(2)) was recorded after induction and during insufflation. RESULTS: Paco(2) increased during insufflation and reached a maximum at extubation. It declined within 20 min postoperatively but did not return to preoperative levels during this time. TcPco(2) levels followed a similar pattern. ETco(2) was significantly lower than Paco(2) after induction and during insufflation. CONCLUSION: TcPco(2) was a valid and practical measurement compared with ETco(2). In patients with COPD undergoing laparoscopic cholecystectomy, TcPco(2) and ETco(2) could be used instead of arterial blood gas sampling