Cardiopulmonary Effects of Intrathoracic Pressure Overshoot During Carbon Dioxide Insufflation in Thoracoscopic Surgery

Cardiopulmonary Effects of Intrathoracic Pressure Overshoot During Carbon Dioxide Insufflation in Thoracoscopic Surgery

Video-assisted thoracoscopic surgery (VATS) has become a standard technique for addressing all types of thoracic pathology. Insufflation of carbon dioxide (CO2) into the operated chest cavity could increase lung collapse and improve surgical field view. The actual thoracic pressure values may not be identical with the presetting on the insufflator display. This overshoot pressure during VATS may compromise cardiac and pulmonary function. The purpose of this study is to evaluate the effects of intrathoracic pressure overshoot during two-lung ventilation on the hemodynamic and respiratory function and clarify the relative safety of two different techniques of insufflation.

Inclusion Criteria:

• American Society of Anesthesiologists (ASA) Physical Status Ⅰ,Ⅱ
• Patients with esophageal carcinoma
• Elective video-assisted thoracic surgery

Exclusion Criteria:

• Allergic to drugs used in the study
• Refusal of VAST
• Arrhythmia or treated with antiarrhythmic drug
• Surgery type were converted to thoracotomy,
• Massive intraoperative blood loss (> 400ml)