Observation and analysis the impact of different laparoscopic surgical positions on respiratory,circulatory functions and postoperative symptoms of patients
CUI Xue-jun, LI Xiu-fen, YAN Bei
Published 2012-10-06
Cite as Chin J Mod Nurs, 2012,18(28): 3356-3360. DOI: 10.3760/cma.j.issn.1674-2907.2012.28.003
Abstract
Objective To investigate the effect of different laparoscopic surgical positions on respiratory and circulatory functions,and postoperative symptoms of patients.Methods Totals of 120 consecutive cases with different laparoscopic surgery positions were included and were divided into three groups with 40 cases each group:reverse trendelenburg position group,trendelenburg position group,and were lateral position group.Heart rate,blood pressure,oxygen saturation,end-tidal carbon dioxide partial pressure,and peak airway pressure (Ppeak) were collected at three time points:5 mins before the start of surgery pneumoperitoneum (T1),10 mins after pneumoperitoneum (T2) and 5 mins after the end of pneumoperitoneum (T3).Postoperative symptoms were recorded as following up.Results In three groups,respectively,the differences in systolic blood pressure,diastolic blood pressure and respiratory carbon dioxide partial pressure (PETCO2) were statistically significant (P < 0.05).The blood pressure of T3 was significantly lower than that of T2 (P<0.01).The level of SBP and DBP of were significantly higher than that of T3 and T1 (P<0.01).No significant difference was detected in the heart rate change,and SpO2 of T2,T3 and T1 (P > 0.05).In reverse trendelenburg position group,the level of Ppeak of T2 was significantly higher than that of T1,while lower than that of T3 (P <0.01).In trendelenburg position group,the levels of Ppeak of T2 and T3 were significantly higher than that of T1 (P < 0.01).No significant difference was found in the levels of Ppeak of lateral position group (P > 0.05).And no significant difference was found in the incidence of abdominal discomfort symptoms between three groups (P > 0.05).The incidence of discomfortable symptoms of reverse trendelenburg position group,trendelenburg position group and ateral position group,respectively was 15.0%,42.5%,15.0%,and the incidence of shoulder paìn after surgery of trendelenburg position group was significantly higher than that of other groups (P < 0.01).Conclusions Pneumoperitoneum pressure and different positions can affect both the respiratory and circulation function of patients that undergoing laparoscopic surgery.And positions may affect the incidence of postoperative shoulder pain.
Key words:
Laparoscopy; Surgical position ; Respiratory and circulatory functions; Influencing factor
Contributor Information
CUI Xue-jun
Operating Room, Beijing Hospital, Beijing 100730, China
LI Xiu-fen
Operating Room, Beijing Hospital, Beijing 100730, China
YAN Bei
Operating Room, Beijing Hospital, Beijing 100730, China