Objective To observe the effects of ventilation with low tidal volume and positive end-expiratory pressure (PEEP) in different periods on the postoperative pulmonary function and short-term prognosis in aged patients undergoing abdominal surgery.
Methods Sixty aged patients undergoing selective open abdominal surgery scheduled for general anesthesia, 21 males and 39 females, were randomized into 3 groups (n=20). Patients in group A received PEEP 1 h after the beginning of surgery; patients in group B received PEEP 1 h before tracheal extubation; patients in group C received PEEP intraoperatively.The secretion score in preoperative, postoperative 24h and 72h respectively, and the arterial blood gas analysis indexes (PaCO2,PaO2,A-aDO2, PaO2/FiO2 calculation) in postoperative 1 h and 24 h were recorded.
Results Compared with preoperative, in postoperative 1 h,PaCO2 increased obviously in all groups, PaO2 decreased in groupB, A-aDO2 increased in group A (P<0.05); in postoperative 24 h, PaCO2 was significantly increased in group B and C, PaO2/FiO2 decreased in group B (P<0.05). Compared with postoperative 1 h, in postoperative 24 h, PaCO2 and A-aDO2 decreased obviously in group A (P<0.05). There were no differences in postoperative secretions score in between the 3 groups.
Conclusion Low tidal volume combined short-range PEEP in different periods of surgery may improve postoperative pulmonary oxygenation. But they had no obvious help with postoperative pulmonary complications. |
