CHANGES IN RESPIRATORY COMPLIANCE AT LAPAROSCOPY - MEASUREMENTS USINGSIDE STREAM SPIROMETRY

In order to quantify changes in total respiratory compliance (C-rs) ef fected by peritoneal pressurization we measured, under standardized an aesthetic conditions and using side stream spirometry C-rs in 32 patie nts scheduled for abdominal surgery through laparoscopic techniques. T o qualify the changes in C-rs as to the type (duration anti patient's position) of surgery, 20 patients having cholecystectomy, eight having gastric fundoplication, and four having inguinal hernia repair were s tudied At CO2 insufflation to a mean intraabdominal pressure of II cmH (2)O in the horizontalposition, C-rs decreased abruptly by 20% in each of the surgical sub-groups (P < 0.05-0.01). During the insufflation p eriod a further deterioration was observed, most pronounced in inguina l hernia patients operated upon in a head-down tilt position (P < 0.05 ). In the cholecystectomy and fundoplication patients, operated upon i n a head-up tilt, the recovery of C-rs was immediate at deflation wher eas an incomplete recovery (P < 0.05 vs initial values) was seen in th e hernia patients. In evaluating all patients none of the demographic factors, age, sex, body-mars-index, intraabdominal pressure, or durati on of pressurization, were associated with the detected changes.