The Effect of Volume Controlled and Pressure Controlled Ventilation Modes on Cerebral Oximetry and Blood Gas Status in Laparoscopic Cholecystectomy, A Randomized Controlled Trial

Abstract

\n Background: To compare the volume-controlled and pressure-controlled ventilation modes with near infrared spectroscopy (NIRS) cerebral oximetry and blood gas status in laparoscopic cholecystectomyMethods: Seventy patients (n=70), who underwent elective laparoscopic cholecystectomy operation were randomized into two groups (volume control ventilation - group V, pressure control ventilation - group P). Demographic data (age, gender, body mass index) and operative data (anesthesia, surgery, and insufflation durations) were recorded. Patients’ single derivation electrocardiogram, pulse oximetry, non-invasive arterial pressure, NIRS cerebral oximetry and end-tidal CO2 parameters were recorded. Measurements were done at the start of anesthesia (T0), at the end of intubation (T1), 5 minutes after the insufflation (T2), at the time just before desufflation (T3) and 5 minutes after desufflation (T4).The patients’ heart rate, systolic and diastolic arterial pressure, saturation of pulse oximetry, and NIRS values were recorded for time points. Additionally, arterial gas results and mechanical ventilation parameters were recorded as well. Results: No significant difference was found in age, sex, body mass index. Operation, anesthesia and insufflation durations were similar for the groups. In Group P, NIRS right T1-2-3 averages and NIRS left T2-3 averages were significantly higher than Group V (p=0.030, p=0.001, p=0.001, p=0.006, p=0.002 respectively). In Group P T1-T2-T4, mean peak pressures and mean plateau pressures were significantly lower than Group V (p=0.003, p=0.001, p<0.001, p=0.011, p=0.001, p<0.001 respectively).Conclusion: Mechanical ventilation that performed in pressure-control ventilation mode is resulted with better tissue oxygenation than volume-control ventilation mode. In pressure-control ventilation mode, peak pressure and plateau pressure were lower.Registration of study at ClinicalTrials.gov was made at 25/01/2021 with the NCT04723043 number.