Comparison Between Volume Controlled Ventilation and Pressure Controlled Ventilation in Laparoscopic Cholecystectomy and their Effects on Hemodynamic and Respiratory Parameters

Abstract

Background: Laparoscopic cholecystectomy is a minimally invasive surgical technique for amputation of an
unhealthy gallbladder. This procedure has several advantages including shorter stay in hospital, minimal postoperative
pain and fast recovery after procedure. The disadvantages of this procedure due to increase intraabdominal
pressure, patient position and general anesthesia. Many of anesthetist apply VCV in this procedure.
VCV can deliver adequate minute volume but this is corresponded by an increase in airway pressure, so other
alternative mode can be used to solve this problem like PCV.
Aim of the Study: To compare effect of volume controlled ventilation versus pressure controlled ventilation on
respiratory and haemodynamic parameters during laproscopic cholycystectomy.
Patients and method: A prospective comparative observational study, conducted at the Department of general
surgery in Baghdad Teaching Hospital/Medical city complex, from October 2019 - October 2020. Fifty participants
underwent laparoscopic cholecystectomy within the inclusion criteria were included in the present study. Each
group consist of 25 patients .one group received VCV and others receive PCV. peak airway pressure, mean airway
pressure, MAP, and heart rate was recorded intraoperatively at 5,10 and 30 minute intervals. The collected data
were analyzed by SSPS version 22 program.
Results: In pressure control group of patients, the peak airway pressure was significantly deceased after 10 and
30minutes after start of laparoscopy (20.2and 20.8) versus (24.3 and 24.1) respectively and mean airway pressure
was significantly increased after same time (10.6 and10.6) versus (9.7 and 9.7) respectively relative to volume
control group. No significant change in hemodynamic parameters. Conclusion: PCV mode is a safe alternative &
offers protection to the lungs but there was no beneficial effect of PCV regarding mean airway pressures which
reflect oxygenation, minute ventilation &ETCO2.