Comparison of gastric insufflation during anesthetic induction between pressure-controlled and manual facemask ventilation in patients undergoing laparoscopic cholecystectomy
Keywords:
Gastric insufflation, gastric ultrasound assessment, laparoscopic cholecystectomy, manual facemask ventilation, pressure controlled facemask ventilationAbstract
For laparoscopic cholecystectomy good visibility of the surgical site is essential, therefore the prevention of gastric insufflation is important. In present study, we compared the incidence of gastric insufflation between pressure controlled and manual facemask ventilation during anesthetic induction. The research participants were 60 patients undergoing laparoscopic cholecystectomy were randomly allocated to pressure controlled facemask ventilation (PCV group) or manual facemask ventilation (MV group). In PCV group (n=30) received pressure controlled facemask ventilation at an inspiratory pressure of 13 cmH2O. In the MV group (n=30), the adjustable pressure limiting valve was set at 13 cmH2O. The incidence of gastric insufflation after ventilation was assessed by gastric ultrasonography and assessing through endoscopic view after started operation by surgeon. The tidal volume during facemask ventilation was also evaluated. The results of the study found the incidence of gastric insufflation assessed by ultrasonography was higher in manual facemask ventilation group than in pressure controlled facemask ventilation group (16.6% vs 6.6%, p-value = 1.45). However, there were not statistically different between the two groups. The tidal volume at 30s and 60s was significantly larger and adequate ventilation in the PCV group (461.5±76.7, 513.9±85.9) than in MV group (366.4±94.5, 400.3±101.6; p-value = 0.001, <0.001, respectively). Additionally, there were no significant differences between the two groups in surgical grade according to surgeon’s judgement. In conclusion pressure controlled facemask ventilation provide appropriate tidal volume compared with manual facemask ventilation at the same inspiratory pressure of 13 cmH2O. However, there was no significant difference in the incidence of gastric insufflation diagnosed with ultrasonography and laparoscopic view between these two ventilation methods.
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