Hypercapnia during transperitoneal and retroperitoneal endoscopic spinal surgery: a prospective study.

STUDY

OBJECTIVE

To evaluate the effect of carbon dioxide (CO(2)) pneumoperitoneum and retropneumoperitoneum insufflation on CO(2) excretion.

DESIGN

Prospective study.

SETTING

Operating room and recovery room in a teaching hospital.

PATIENTS: 29 patients scheduled for orthopedic spine fusion surgery.

INTERVENTIONS: Patients received either transperitoneal insufflation (n = 12) or retroperitoneal insufflation (n = 17).

MEASUREMENTS AND MAIN

RESULTS

Increases in the partial pressure of end-tidal CO(2) (PetCO(2)) and arterial CO(2) tension (PaCO(2)) during retropneumoperitoneum exceeded those obtained during pneumoperitoneum. Furthermore, PetCO(2) increased faster during retroperitoneum and did not reach a plateau. Finally, 76% of the patients in this group required ventilatory adjustment due to high PetCO(2) levels.

CONCLUSIONS

This study may focus attention on the need for continuous ventilatory adjustments during transperitoneal endoscopic surgery.