Effect of PCV-VG Mode Combined with Dexmedetomidine on Intraoperative Respiratory Mechanics and Blood Gas Indicators in Patients Undergoing Laparoscopic Sleeve Gastrectomy

Hongmei BAO; Rong QIN; Yu ZHANG; Meiju YANG; Gang SU

doi:10.12259/j.issn.2095-610X.S20240917

Volume 45 Issue 9

Sep. 2024

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Article Navigation > Journal of Kunming Medical University > 2024 > 45(9): 110-115

Hongmei BAO, Rong QIN, Yu ZHANG, Meiju YANG, Gang SU. Effect of PCV-VG Mode Combined with Dexmedetomidine on Intraoperative Respiratory Mechanics and Blood Gas Indicators in Patients Undergoing Laparoscopic Sleeve Gastrectomy[J]. Journal of Kunming Medical University, 2024, 45(9): 110-115. doi: 10.12259/j.issn.2095-610X.S20240917

Citation:

Hongmei BAO, Rong QIN, Yu ZHANG, Meiju YANG, Gang SU. Effect of PCV-VG Mode Combined with Dexmedetomidine on Intraoperative Respiratory Mechanics and Blood Gas Indicators in Patients Undergoing Laparoscopic Sleeve Gastrectomy[J]. Journal of Kunming Medical University, 2024, 45(9): 110-115. doi: 10.12259/j.issn.2095-610X.S20240917

Citation:

Hongmei BAO, Rong QIN, Yu ZHANG, Meiju YANG, Gang SU. Effect of PCV-VG Mode Combined with Dexmedetomidine on Intraoperative Respiratory Mechanics and Blood Gas Indicators in Patients Undergoing Laparoscopic Sleeve Gastrectomy[J]. Journal of Kunming Medical University, 2024, 45(9): 110-115. doi: 10.12259/j.issn.2095-610X.S20240917

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Effect of PCV-VG Mode Combined with Dexmedetomidine on Intraoperative Respiratory Mechanics and Blood Gas Indicators in Patients Undergoing Laparoscopic Sleeve Gastrectomy

doi: 10.12259/j.issn.2095-610X.S20240917

Dept. of Anesthesiology，The 1st People’s Hospital of Kunming，Kunming Yunnan 650034，China

Received Date: 2024-04-16
Available Online: 2024-09-04
Publish Date: 2024-09-25

Abstract

Abstract

Objective To explore the effects of PCV-VG ventilation mode combined with dexmedetomidine sedation on intraoperative respiratory mechanics and blood gas indicators in obese patients undergoing laparoscopic sleeve gastrectomy. Methods 132 patients who underwent laparoscopic sleeve gastrectomy at Kunming First People's Hospital from July 2022 to December 2023 were randomly divided into VCV mode group （Group V）, PCV-VG mode group （Group P）, VCV mode combined with dexmedetomidine pump group （Group D）, and PCV-VG mode combined with dexmedetomidine pump group （Group PD）, with 33 patients in each group. Then we compared the oxygen partial pressure （PaO₂）, carbon dioxide partial pressure （PaCO₂）, peak airway pressure （P_peak）, mean airway pressure （P_mean）, and lung dynamic compliance （C_dyn） of four groups of patients 20 minutes before anesthesia induction （T0）, 10 minutes after tracheal intubation （T1）, 40 minutes after CO₂ pneumoperitoneum establishment （T2）, and 10 minutes after deflation （T3）. Results （1） Blood gas indicators: At time points T2 and T3, the PaO₂ levels in the P, D, and PD groups were higher than those in the V group, with P < 0.01, indicating a statistically significant difference, Among them, the PD group was higher than the other three groups, with P < 0.01, indicating a statistically significant difference; And PaCO₂ was lower than that of Group V, P < 0.01, with statistically significant differences, Among them, the PD group was lower than the other three groups, P < 0.01, with statistically significant differences. （2） Respiratory mechanics indicators: At T1, there was no significant statistical difference in P_peak among the four groups, with P > 0.05. The P_peak of the PD group was lower than that of the V, P, and D groups at time points T2 and T3, with P < 0.01, and the difference was statistically significant; And C_dyn was higher than the other three groups, with P < 0.01, and the difference was statistically significant; At T1, T2, and T3, P_mean was lower in the PD group than in the P group, with P < 0.01, and the difference was statistically significant. Conclusion PCV-VG ventilation mode combined with intravenous infusion of dexmedetomidine can improve oxygen and function during laparoscopic sleeve gastrectomy in obese patients, reduce airway peak pressure, improve lung compliance, and reduce mechanical lung injury.
- PCV-VG,
- Dexmedetomidine,
- Laparoscopic sleeve gastrectomy,
- Blood gas,
- Respiratory mechanics

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References(16)

References

[1]	熊利泽,邓小明. 2017版中国麻醉学指南与专家共识[M]. 北京: 人民卫生出版社,2017: 104.
[2]	中国疾病预防控制中心,国家癌症中心,国家心血管病中心. 中国居民营养与慢性病状况报告(2020年)[J]. 营养学报,2020,42(6):521.
[3]	大中华减重与代谢手术数据库研究者团队. 大中华减重与代谢手术数据库2020年度报告[J]. 中国实用外科杂志,2021,41(5):533-542.
[4]	杨华,陈缘,董志勇,等. 中国肥胖代谢外科数据库: 2020年度报告[J]. 中华肥胖与代谢病电子杂志,2021,7(1):1-7. doi: 10.3877/cma.j.issn.2095-9605.2021.01.001
[5]	English W J,DeMaria E J,Hutter M M,et al. American society for metabolic and bariatric surgery 2018 estimate of metabolic and bariatric procedures performed in the United States[J]. Surg Obes Relat Dis,2020,16(4):457-463. doi: 10.1016/j.soard.2019.12.022
[6]	王跃东. 腹腔镜袖状胃切除术治疗肥胖症[J]. 浙江医学,2018,40(24):2621-2623. doi: 10.12056/j.issn.1006-2785.2018.40.24.2018-1310
[7]	Lamaia,Sillva P L,Pelosi P,et al. Controlled invasive me-chanical ventilation strategies in obese patients undergoing sur-gery[J]. Expert Rev Respir Med,2017,11(6):443-452. doi: 10.1080/17476348.2017.1322510
[8]	曾渊,剻建科,毛延坤,等. 右美托咪定对肺癌根治术患者围术期脑功能、肺功能保护及应激相关指标的影响[J]. 临床肺科杂志,2018,23(12):2268-2272. doi: 10.3969/j.issn.1009-6663.2018.12.034
[9]	中国医师协会外科医师分会肥胖和糖尿病外科医师委员会. 中国肥胖及2型糖尿病外科治疗指南(2019)[J]. 中国实用外科杂志,2019,39(4):301-306.
[10]	Janmahasatian S,Dffull S B,Ash S,et al. Quantification of lean bodyweight[J]. Clin Pharmacokinet,2005,44(10):1051-1065.
[11]	Kirov M Y,Kuzkov V V. Protective ventilation from ICU to operating room: State of art and new horizons[J]. Korean J Anesthesiol,2020,73(3):179-193.
[12]	钟海莲,刘余钱,郝伟,等. 基于肺超声评分评估压力控制容量保证通气模式对腹腔镜胃癌根治术患者肺通气的影响[J]. 临床麻醉学杂志,2022,38(10):1041-1046. doi: 10.12089/jca.2022.10.006
[13]	俞贝贝,赵国庆,宋知遥,等. 右美托咪定在病态肥胖患者减重手术中的应用研究进展[J]. 中国实验诊断学,2021,25(1):147-150.
[14]	Sugasawa Y,Yamaguchi K,Kumakura S,et al. The effect of onelung ventilation upon pulmonary inflammatory responses during lung resection[J]. J Anesth,2011,25(2):170-177. doi: 10.1007/s00540-011-1100-0
[15]	Liu Z,Wang Y,Wang Y,et al. Dexmedetomidine attenuates inflammatory reaction in the lung tissues of septic mice by activating cholinergic anti-inflammatory pathway[J]. Int Immunopharmacol,2016,35(3):210-216.
[16]	Lee S H,Kim N,Lee C Y,et al. Effects of dexmedetomidine on oxygenation and lung mechanics in patients with moderate chronic obstructive pulmonary disease undergoing lung cancer surgery: A randomised double-blinded trial[J]. Eur J Anaesthesiol,2016,33(4): 275.

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