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Khirurgii

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Year 2011 Vol. 19 No 4

GENERAL AND SPECIAL SURGERY

V.E. KORIK, S.A. ZHIDKOV, А.А. MAKOVSKAYA, D.A. KLYUYKO

COMPARATIVE CHARACTERISTICS OF PNEUMOPERITONEUM INFLUENCE WITH THE USEOF VARIOUS GAS MIXTURES ON THE BLOOD ACID-BASE STATE AT LAPAROSCOPIC SURGERIES

Objectives. The estimation of influence of carbon dioxide and artificial air insufflated into abdomen on the blood acid-base state in patients subjected to laparoscopic cholecystectomy.
Methods. All the patients tested have been divided into two accidental groups. In the first group (20 patients) carbon dioxide was used for the abdomen insufflation. The second group was composed of 27 patients in whom the artificial air consisting of О2 and N2 (21% and 79% respectively) was used for pneumoperitoneum attachment during the operation.
Results. Changes of the acid-base balance at the laparoscopic surgeries with the carbon dioxide use testify to the fact that patients by the middle of not long-lasting surgery are in the hidden metabolic acidosis; normal parameters of the partial pressure of СО2 also prove this. Application of the air gaseous mixture for pneumoperitoneum at the laparoscopic surgeries doesnt lead to significant changes of acid-base balance parameters; besides, negative outcomes of electro coagulation use during the operation havent been registered at the given gaseous medium application.
Conclusions. Application of carbon dioxide at laparoscopic surgeries leads to reliable decrease of the venous blood рН. The signs of the metabolic acidosis are also displayed by the reliable decrease of the normal bicarbonate level and base deficiency development at normal РaСО2 parameters. Use of the air medium for pneumoperitoneum at the laparoscopic surgeries doesn,t influence significantly the acid-base state of the organism.

Keywords: cholecystectomy, laparoscopy, acid-base state, metabolic acidosis
p. 31 – 35 of the original issue
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