Publication:

A comparison of airway pressure changes in volume-controlled ventilation versus pressure-controlled ventilation with similar tidal volumes in laparoscopic surgery

Background Whether pressure-controlled ventilation (PCV) is superior to volume-controlled ventilation (VCV) during laparoscopic surgery remains debatable. The strength and uniformity of the evidence on this topic have not been thoroughly examined, representing a significant gap in our knowledge of the comparative benefits of PCV versus VCV in laparoscopic surgery. The present study compared airway pressure changes between PCV and VCV using similar tidal volumes in patients undergoing laparoscopic procedures.

Methods Seventy patients aged between 20 and 70 years, scheduled to undergo laparoscopic surgery and American Society of Anesthesiologists grades I-II, were randomly divided into two groups by computer-generated tables. Group A patients were given VCV after induction of pneumoperitoneum, while group B patients were given PCV after induction of pneumoperitoneum. Airway pressure changes and hemodynamic parameters were measured at 15-minute intervals until the end of the procedure. The primary objective was to compare peak pressure (P-peak) between the two groups, while the secondary objectives were to compare plateau pressure (P-plat), minute volume, and hemodynamic changes.

Results The haemodynamic parameters were comparable at baseline and up to 75 minutes post-procedure. From the 15th minute onwards post-surgery, the mean P-peak, P-plat were significantly lower in the PCV group as compared with the VCV group till the 60th minute post-procedure. The mean minute volume and positive end-expiratory pressure were significantly lower in the VCV than the PCV group at the 30th and 45th minute.

Conclusion The PCV is better than VCV in patients undergoing laparoscopic surgery.