Does cerebral oxygenization of end-tidal carbondioxide changes due to intraabdominal carbondioxide insulation in gynecological laparoscopic operations?

Laparoscopic surgery in recent years; A popular surgical procedure that requires less invasive intervention, leads to better cosmetic results, reduces hospitalization and therefore decreases medical expenditures, causes fewer postoperative complications and postoperative pain has become technically technical. Nowadays, laparoscopic surgery is used as the first choice for the diagnosis and treatment of many gynecological diseases. In laparoscopic surgery, Pneumoperitoneum should be created to ensure adequate image and placement of Trocaras. In the formation of pneumoperitoneum, distension is often provided with carbon dioxide (CO2). However, CO2 is rapidly absorbed from the peritoneal cause of hypercarbi and acidosis. In studies; It was determined that carbon dioxide insuflation could cause changes in cardiovascular, respiratory and acid-base balance, as a result of various changes in cerebral perfusion and oxygenation. A total of 43 patients received in the laparoscopic operation with gynecologic indications were enrolled in this study. The patients were divided into 2 groups according to the EtCO2 values on the monitored monitor during the operation. Group 1 was considered to be a moderate hypocarbic and group 2 was treated as patient groups with moderate hypercarbic. All patients were pre-anaesthesia (T1), after Anesthesia (T2), in insuflation (T3), after 20. minutes (T4), 50. minutes (T5), 80. minutes (T6), after the desufflation (T7), after the Extubation (T8) hemodynamic data and the values of the NIRS were recorded. All patients also preoperative 1 hour before and postoperative 1. Per hour SMMT applied. There was no significant difference between the groups while the duration of the operation was determined by the EtCO2, PaCO2 and NIRS values. However, in only 1 patient who participated in the study, cerebral desaturation was detected due to bronchospasm after extubation. Consequently, in patients independent of intraoperative EtCO2 values; due to the CO2 infertility of laparoscopic surgery, the increase in the values of the NIRS was observed in relation to time. In addition, postoperative SMMT scores of patients were higher than their course values. We think that this result is related to the vasodilation of carbondioxide gas on cerebral vessels. However, this result did not make a significant clinical difference. Key words: Near-Infrared Spectroscopy; Laparoscopy; Cerebral perfusion; Gynecologic anesthesia; Mini Mental Status Examination