Arterial Blood Gas Analysis in Laparoscopic Cholecystectomy
Keywords
Abstract
Description
Laparoscopic cholecystectomy procedure is the treatment of choice for cholelithiasis as it has several advantages like smaller and more cosmetic incision, reduced blood loss, less postoperative pain, reduced post-operative stay, low post-operative complications, and early mobilization. Although this type of surgery is minimally invasive in nature but creation of pneumoperitoneum and postural changes causes a number of physiological alterations. Carbon dioxide (CO2) is the most commonly used gas for this purpose because it does not support combustion, is cleared more rapidly than other gases, and is highly soluble in blood. However, the disadvantage of CO2 is that the absorption of CO2 can cause hypercapnia and respiratory acidosis. Hypercapnia activates the sympathetic nervous system leading to an increase in blood pressure, heart rate, arrhythmias and myocardial contractility as well as it also sensitizes myocardium to catecholamines. Increased IAP may compress venous vessels causing an initial increase in preload, followed by a sustained decrease in preload.
Tobacco smoking is an internationally accepted health hazard. The United nation (UN) health agency reports that about 4.9 million people die each year across the globe due to cigarette smoking. Chronic smoking (more than 20 pack year at least for 10 year) causes a number of pathological changes in respiratory system which includes inflammatory changes in lung parenchyma, imbalance between protease and anti-protease, oxidative stress, cilliary dysfunction, mucosal hyper secretion, airflow limitation and pulmonary hypertension.
Arterial blood gas analysis plays a very important role in assessing the acid-base status, adequacy of oxygenation and ventilation. It is very useful in management of critically ill patients and in patients with pulmonary disorders. It is also a standard part of work-up for the patients who present with unexplained hypoxemia and dyspnea. An ABG test uses blood drawn from an artery, where the oxygen and carbon dioxide levels can be measured before they enter body tissues.
Dates
| Last Verified: | 04/30/2017 |
| First Submitted: | 03/11/2017 |
| Estimated Enrollment Submitted: | 04/24/2017 |
| First Posted: | 04/27/2017 |
| Last Update Submitted: | 05/14/2017 |
| Last Update Posted: | 05/16/2017 |
| Actual Study Start Date: | 03/31/2015 |
| Estimated Primary Completion Date: | 03/31/2016 |
| Estimated Study Completion Date: | 03/31/2016 |
Condition or disease
Intervention/treatment
Other: ABG analysis
Phase
Arm Groups
| Arm | Intervention/treatment |
|---|---|
| Active Comparator: Laparoscopic cholecystectomy in smokers ABG analysis of patients with history of smoking posted for laparoscopic cholecystectomy was collected | |
| Placebo Comparator: Laparoscopic cholecystectomy nonsmokers ABG analysis of patients without history of smoking posted for laparoscopic cholecystectomy was collected |
Eligibility Criteria
| Ages Eligible for Study | 20 Years To 20 Years |
| Sexes Eligible for Study | All |
| Accepts Healthy Volunteers | Yes |
| Criteria | Inclusion Criteria: - American society of Anesthesiology (ASA) grade 1 and 2 - History of smoking (more than 20 pack year) for more than 10years Exclusion Criteria: - Patients refusal - ASA grade 3 and 4 - Other lung pathologies - Other cardiac pathologies - uncontrolled diabetes mellitus - systemic infection - emergency operation - history of malignancy - history of alcohol or drug abuse |
Outcome
Primary Outcome Measures
1. Arterial blood gas parameter like potential of hydrogen (PH) [10 minutes before starting to 30 minutes after completion of surgery]
Secondary Outcome Measures
1. Arterial blood gas parameter like partial pressure of carbon dioxide (PCO2) [10 minutes before starting to 30 minutes after completion of surgery]
2. Arterial blood gas parameter like bicarbonate(HCO3) [10 minutes before starting to 30 minutes after completion of surgery]
3. Arterial blood gas parameter like base excess (BE) [10 minutes before starting to 30 minutes after completion of surgery]
