Progress of controlled hyperventilation in laparoscopic surgery_West China Medical Journal

Authors：

 DAI Lingjie ¹ , YUAN Qingxia ²

1. Department of Anesthesia, Yan’an University Affiliated Hospital, Yan’an, Shaanxi 716000, P. R. China;
2. Department of Critical Care Medicine, Yan’an University Affiliated Hospital, Yan’an, Shaanxi 716000, P. R. China;

Corresponding?author：

DAI Lingjie, Email: 1320352157@qq.com

Keywords：

Hyperventilation; Laparoscopy; Carbon dioxide pneumoperitoneum; Hypercapnia

DOI：

10.7507/1002-0179.201909173

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

With the extensive application of laparoscopy in clinical surgery, the advantages of laparoscopic surgery such as less intraoperative bleeding, small and beautiful incision, and rapid postoperative recovery become increasingly prominent. However, prolonged use of carbon dioxide (CO₂) pneumoperitoneum or high CO₂ pneumoperitoneum pressure during laparoscopic surgery may cause subcutaneous emphysema and hypercapnia, in severe cases which may affect the quality of recovery and prognosis of patients. The use of a protective ventilation strategy during laparoscopic surgery under general anesthesia, a mechanical ventilation model of controlled hyperventilation, can reduce or avoid the effects of hypercapnia caused by prolonged CO₂ pneumoperitoneum or high CO₂ pneumoperitoneum pressure. This article reviews the effects of laparoscopic CO₂ pneumoperitoneum on patients, the application of controlled hyperventilation in laparoscopic surgery under general anesthesia and the effects of controlled hyperventilation on patients. The aim is to provide a theoretical basis for the safe and effective application of controlled hyperventilation in laparoscopic surgery.

Citation： DAI Lingjie, YUAN Qingxia. Progress of controlled hyperventilation in laparoscopic surgery. West China Medical Journal, 2020, 35(2): 220-224. doi: 10.7507/1002-0179.201909173 Copy

1.	樊利華, 游存厚, 姜雯. 腹腔鏡手術中 CO₂ 氣腹對機體生理功能的影響. 疾病監測與控制, 2017, 11(9): 708-710.
2.	萬玉驍, 朱俊超. 肺保護性通氣策略在新生兒胸腔鏡手術中對腦氧飽和度的影響. 中國醫科大學學報, 2018, 47(5): 385-389.
3.	高志剛, 劉群. 保護性肺通氣的研究與應用. 醫學綜述, 2004, 10(10): 618-620.
4.	Heffner JE, Sahn SA. Controlled hyperventilation in patients with intracranial hypertension. Application and management. Arch Intern Med, 1983, 143(4): 765-769.
5.	梁仕偉, 林春水, 古妙寧. 輕度過度通氣下施行 CO₂ 氣腹對呼吸和動脈血氣的影響. 第一軍醫大學學報, 2001, 21(2): 121-122, 125.
6.	Buijze GA, Hopman MT. Controlled hyperventilation after training may accelerate altitude acclimatization. Wilderness Environ Med, 2014, 25(4): 484-486.
7.	Talakoub R, Khodayari A, Saghaei M. Effect of controlled hyperventilation on the pressor response to laryngoscopy and tracheal intubation. Middle East J Anaesthesiol, 2003, 17(3): 403-413.
8.	辛棟軼, 蔣金偉, 解晶, 等. 不同氣腹壓力對腹腔鏡膽囊切除術后肝功能、炎癥因子及免疫功能的影響. 現代實用醫學, 2016, 28(2): 227-229.
9.	Schietroma M, Pessia B, Stifini D, et al. Effects of low and standard intra-abdominal pressure on systemic inflammation and immune response in laparoscopic adrenalectomy: a prospective randomised study. J Minim Access Surg, 2016, 12(2): 109-117.
10.	Roh GU, Kim WO, Rha KH, et al. Prevalence and impact of incompetence of internal jugular valve on postoperative cognitive dysfunction in elderly patients undergoing robot-assisted laparoscopic radical prostatectomy. Arch Gerontol Geriatr, 2016, 64: 167-171.
11.	Rauh R, Hemmerling TM, Rist M, et al. Influence of pneumoperitoneum and patient positioning on respiratory system compliance. J Clin Anesth, 2001, 13(5): 361-365.
12.	王磊, 吳婧, 楊麗娜, 等. 允許性高碳酸血癥在腹腔鏡直腸癌手術中的應用及對循環的影響. 現代生物醫學進展, 2019, 19(11): 2167-2171.
13.	尹增盛, 李淑琴, 崔輝. 不同壓力二氧化碳氣腹對老年腹腔鏡膽囊切除術患者術后認知功能的影響. 醫學信息, 2018, 31(20): 86-87, 90.
14.	徐輝, 郭永章, 陳訓如. CO₂ 氣腹對正常大鼠腦組織 S-100、NSE mRNA 和蛋白水平的影響. 消化外科, 2006, 5(4): 274-277.
15.	Li XM, Shao MT, Wang JJ, et al. Relationship between post-operative cognitive dysfunction and regional cerebral oxygen saturation and β-amyloid protein. J Zhejiang Univ Sci B, 2014, 15(10): 870-878.
16.	Cleutjens FA, Janssen DJ, Ponds RW, et al. Cognitive-pulmonary disease. Biomed Res Int, 2014, 2014: 697825.
17.	左艷霞, 秦壽澤, 張鳳敏, 等. 婦科腹腔鏡手術中氣腹與非氣腹對呼吸、循環功能及眼內壓影響的比較. 疑難病雜志, 2016, 15(7): 720-724.
18.	Dec M, Andruszkiewicz P. Anaesthesia for minimally invasive surgery. Wideochir Inne Tech Maloinwazyjne, 2016, 10(4): 509-514.
19.	蒙炯, 萬智恒, 祁鳳靈. 腹腔鏡手術中二氧化碳氣腹副作用的研究現狀. 中國傷殘醫學, 2015, 23(6): 212-213.
20.	王玉順. 不同通氣策略配合低壓力二氧化碳氣腹在后腹腔鏡手術中的運用. 臨床醫藥文獻電子雜志, 2018, 5(50): 67, 69.
21.	Nasajiyan N, Javaherfourosh F, Ghomeishi A, et al. Comparison of low and standard pressure gas injection at abdominal cavity on postoperative nausea and vomiting in laparoscopic cholecystectomy. Pak J Med Sci, 2014, 30(5): 1083-1087.
22.	楊德君, 傅紅兵, 程亞軍, 等. 腹腔鏡胃癌根治術不同氣腹壓力對腸道的影響. 中華胃腸外科雜志, 2014, 17(2): 163-167.
23.	黃潤強, 郭振鵬, 袁修瓊, 等. 低分子肝素鈣在婦科腫瘤腹腔鏡術后預防深靜脈血栓中的臨床效果. 現代腫瘤醫學, 2017, 25(3): 444-447.
24.	萬亮, 李忠廉, 張西波. 腹腔鏡與開腹膽囊切除術后凝血及纖溶系統的變化. 山東醫藥, 2014, 54(32): 82-84.
25.	王欣. CO₂ 氣腹腹腔鏡手術對凝血/纖溶系統的影響. 石家莊: 河北醫科大學, 2008.
26.	周志濤, 何偉良, 范隼, 等. 腹腔鏡膽囊切除術氣腹時間對患者凝血、纖溶系統活性及血管內皮細胞活性的影響. 四川醫學, 2018, 39(11): 1238-1241.
27.	Larsen JF, Ejstrud P, Svendsen F, et al. Systemic response in patients undergoing laparoscopic cholecystectomy using gasless or carbon dioxide pneumoperitoneum: a randomized study. J Gastrointest Surg, 2002, 6(4): 582-586.
28.	王亞男, 黃向華, 王振海. 腹腔鏡手術對機體內分泌及代謝影響的研究進展. 國外醫學 (婦產科學分冊), 2005, 32(4): 250-253.
29.	王蕾蕾, 黃貞玲, 周仁龍, 等. 腹腔與腹膜后二氧化碳氣腹對抗利尿激素、醛固酮和尿量的影響. 上海醫學, 2015, 38(12): 891-895.
30.	姚明, 常向陽, 方芬. 全身麻醉蘇醒延遲 8 例的教訓與處理. 臨床麻醉學雜志, 1998, 14(3): 202.
31.	王鵬. 后腹腔鏡腎切除術致廣泛皮下氣腫并蘇醒延遲 1 例報告. 腹腔鏡外科雜志, 2016, 21(3): 180, 188.
32.	冉雪蓮, 陳峻. 腹腔鏡結直腸手術后二氧化碳殘留對患者蘇醒質量的影響. 中國臨床新醫學, 2016, 9(9): 794-798.
33.	段波, 黃勝, 陳葒, 等. 高壓氧治療腹腔鏡手術麻醉蘇醒延遲 1 例. 重慶醫學, 2006, 35(19): 1750.
34.	王效德, 郭素香, 董希瑋, 等. 輕度過度通氣對婦科腹腔鏡手術患者麻醉恢復期及 S-100β、NSE 的影響. 山東醫藥, 2012, 52(40): 82-85.
35.	王純輝, 李元海, 徐志榮, 等. 過度通氣對腹腔鏡手術 CO₂ 氣腹前后 P_ETCO₂ 及動脈血氣的影響. 安徽醫科大學學報, 2002, 37(4): 309-311.
36.	安爾丹, 祝勝美. 后腹腔鏡手術中不同通氣策略對動脈血氣參數的影響. 浙江醫學, 2008, 30(12): 1319-1320.
37.	袁燕波, 顏明. 氣管插管后行過度通氣對后腹腔鏡手術患者術中肺功能的影響. 醫學研究雜志, 2018, 47(9): 147-150.
38.	Jo YY, Kwak HJ. What is the proper ventilation strategy during laparoscopic surgery?. Korean J Anesthesiol, 2017, 70(6): 596-600.
39.	劉禮軍, 王強, 鮑方, 等. 單肺通氣時吸入不同濃度氧對圍術期氧合的影響. 臨床麻醉學雜志, 2015, 31(4): 350-353.

1. 樊利華, 游存厚, 姜雯. 腹腔鏡手術中 CO₂ 氣腹對機體生理功能的影響. 疾病監測與控制, 2017, 11(9): 708-710.
2. 萬玉驍, 朱俊超. 肺保護性通氣策略在新生兒胸腔鏡手術中對腦氧飽和度的影響. 中國醫科大學學報, 2018, 47(5): 385-389.
3. 高志剛, 劉群. 保護性肺通氣的研究與應用. 醫學綜述, 2004, 10(10): 618-620.
4. Heffner JE, Sahn SA. Controlled hyperventilation in patients with intracranial hypertension. Application and management. Arch Intern Med, 1983, 143(4): 765-769.
5. 梁仕偉, 林春水, 古妙寧. 輕度過度通氣下施行 CO₂ 氣腹對呼吸和動脈血氣的影響. 第一軍醫大學學報, 2001, 21(2): 121-122, 125.
6. Buijze GA, Hopman MT. Controlled hyperventilation after training may accelerate altitude acclimatization. Wilderness Environ Med, 2014, 25(4): 484-486.
7. Talakoub R, Khodayari A, Saghaei M. Effect of controlled hyperventilation on the pressor response to laryngoscopy and tracheal intubation. Middle East J Anaesthesiol, 2003, 17(3): 403-413.
8. 辛棟軼, 蔣金偉, 解晶, 等. 不同氣腹壓力對腹腔鏡膽囊切除術后肝功能、炎癥因子及免疫功能的影響. 現代實用醫學, 2016, 28(2): 227-229.
9. Schietroma M, Pessia B, Stifini D, et al. Effects of low and standard intra-abdominal pressure on systemic inflammation and immune response in laparoscopic adrenalectomy: a prospective randomised study. J Minim Access Surg, 2016, 12(2): 109-117.
10. Roh GU, Kim WO, Rha KH, et al. Prevalence and impact of incompetence of internal jugular valve on postoperative cognitive dysfunction in elderly patients undergoing robot-assisted laparoscopic radical prostatectomy. Arch Gerontol Geriatr, 2016, 64: 167-171.
11. Rauh R, Hemmerling TM, Rist M, et al. Influence of pneumoperitoneum and patient positioning on respiratory system compliance. J Clin Anesth, 2001, 13(5): 361-365.
12. 王磊, 吳婧, 楊麗娜, 等. 允許性高碳酸血癥在腹腔鏡直腸癌手術中的應用及對循環的影響. 現代生物醫學進展, 2019, 19(11): 2167-2171.
13. 尹增盛, 李淑琴, 崔輝. 不同壓力二氧化碳氣腹對老年腹腔鏡膽囊切除術患者術后認知功能的影響. 醫學信息, 2018, 31(20): 86-87, 90.
14. 徐輝, 郭永章, 陳訓如. CO₂ 氣腹對正常大鼠腦組織 S-100、NSE mRNA 和蛋白水平的影響. 消化外科, 2006, 5(4): 274-277.
15. Li XM, Shao MT, Wang JJ, et al. Relationship between post-operative cognitive dysfunction and regional cerebral oxygen saturation and β-amyloid protein. J Zhejiang Univ Sci B, 2014, 15(10): 870-878.
16. Cleutjens FA, Janssen DJ, Ponds RW, et al. Cognitive-pulmonary disease. Biomed Res Int, 2014, 2014: 697825.
17. 左艷霞, 秦壽澤, 張鳳敏, 等. 婦科腹腔鏡手術中氣腹與非氣腹對呼吸、循環功能及眼內壓影響的比較. 疑難病雜志, 2016, 15(7): 720-724.
18. Dec M, Andruszkiewicz P. Anaesthesia for minimally invasive surgery. Wideochir Inne Tech Maloinwazyjne, 2016, 10(4): 509-514.
19. 蒙炯, 萬智恒, 祁鳳靈. 腹腔鏡手術中二氧化碳氣腹副作用的研究現狀. 中國傷殘醫學, 2015, 23(6): 212-213.
20. 王玉順. 不同通氣策略配合低壓力二氧化碳氣腹在后腹腔鏡手術中的運用. 臨床醫藥文獻電子雜志, 2018, 5(50): 67, 69.
21. Nasajiyan N, Javaherfourosh F, Ghomeishi A, et al. Comparison of low and standard pressure gas injection at abdominal cavity on postoperative nausea and vomiting in laparoscopic cholecystectomy. Pak J Med Sci, 2014, 30(5): 1083-1087.
22. 楊德君, 傅紅兵, 程亞軍, 等. 腹腔鏡胃癌根治術不同氣腹壓力對腸道的影響. 中華胃腸外科雜志, 2014, 17(2): 163-167.
23. 黃潤強, 郭振鵬, 袁修瓊, 等. 低分子肝素鈣在婦科腫瘤腹腔鏡術后預防深靜脈血栓中的臨床效果. 現代腫瘤醫學, 2017, 25(3): 444-447.
24. 萬亮, 李忠廉, 張西波. 腹腔鏡與開腹膽囊切除術后凝血及纖溶系統的變化. 山東醫藥, 2014, 54(32): 82-84.
25. 王欣. CO₂ 氣腹腹腔鏡手術對凝血/纖溶系統的影響. 石家莊: 河北醫科大學, 2008.
26. 周志濤, 何偉良, 范隼, 等. 腹腔鏡膽囊切除術氣腹時間對患者凝血、纖溶系統活性及血管內皮細胞活性的影響. 四川醫學, 2018, 39(11): 1238-1241.
27. Larsen JF, Ejstrud P, Svendsen F, et al. Systemic response in patients undergoing laparoscopic cholecystectomy using gasless or carbon dioxide pneumoperitoneum: a randomized study. J Gastrointest Surg, 2002, 6(4): 582-586.
28. 王亞男, 黃向華, 王振海. 腹腔鏡手術對機體內分泌及代謝影響的研究進展. 國外醫學 (婦產科學分冊), 2005, 32(4): 250-253.
29. 王蕾蕾, 黃貞玲, 周仁龍, 等. 腹腔與腹膜后二氧化碳氣腹對抗利尿激素、醛固酮和尿量的影響. 上海醫學, 2015, 38(12): 891-895.
30. 姚明, 常向陽, 方芬. 全身麻醉蘇醒延遲 8 例的教訓與處理. 臨床麻醉學雜志, 1998, 14(3): 202.
31. 王鵬. 后腹腔鏡腎切除術致廣泛皮下氣腫并蘇醒延遲 1 例報告. 腹腔鏡外科雜志, 2016, 21(3): 180, 188.
32. 冉雪蓮, 陳峻. 腹腔鏡結直腸手術后二氧化碳殘留對患者蘇醒質量的影響. 中國臨床新醫學, 2016, 9(9): 794-798.
33. 段波, 黃勝, 陳葒, 等. 高壓氧治療腹腔鏡手術麻醉蘇醒延遲 1 例. 重慶醫學, 2006, 35(19): 1750.
34. 王效德, 郭素香, 董希瑋, 等. 輕度過度通氣對婦科腹腔鏡手術患者麻醉恢復期及 S-100β、NSE 的影響. 山東醫藥, 2012, 52(40): 82-85.
35. 王純輝, 李元海, 徐志榮, 等. 過度通氣對腹腔鏡手術 CO₂ 氣腹前后 P_ETCO₂ 及動脈血氣的影響. 安徽醫科大學學報, 2002, 37(4): 309-311.
36. 安爾丹, 祝勝美. 后腹腔鏡手術中不同通氣策略對動脈血氣參數的影響. 浙江醫學, 2008, 30(12): 1319-1320.
37. 袁燕波, 顏明. 氣管插管后行過度通氣對后腹腔鏡手術患者術中肺功能的影響. 醫學研究雜志, 2018, 47(9): 147-150.
38. Jo YY, Kwak HJ. What is the proper ventilation strategy during laparoscopic surgery?. Korean J Anesthesiol, 2017, 70(6): 596-600.
39. 劉禮軍, 王強, 鮑方, 等. 單肺通氣時吸入不同濃度氧對圍術期氧合的影響. 臨床麻醉學雜志, 2015, 31(4): 350-353.

Previous Article
Exploration and practice of demand-oriented health poverty alleviation model in Ganzi Prefecture
Next Article
Review of FLASH Radiotherapy

West China Medical Journal

Progress of controlled hyperventilation in laparoscopic surgery

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content