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

ABSTRACT

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.