Functional residual capacity (FRC) changes in laparoscopic surgery and the effect of recruitment manever on functional residual capacity

Aim: This study primarily aimed to compare the functional residuel capacity (FRC) and static compliance (Cs) values for laparoscopic cholecystectomy for mechanical ventilation and general anesthesia, recruited and non-recruited patients. The secondary aim of this study is compare the room air test values for the determined to atelectasis, recruited and non-recruited patients. Materials and Methods: : Following the approval of Ethical Committee and informed consent, 48 patients undergoing laparoscopic cholecystectomy were included to the study. At the specified times of the protocol ; FRC and static compliance were measured. Functional residual capacity (FRC) and static compliance measurements were repeated by performing in the study group. Basal measurements were taken after intubation. In the study group, a recruitment maneuver (15-second with 30 cmH2O) was performed before the pneumoperitoneum and the measurements were taken again in the study group. Measurements were repeated in both groups with pneumoperitoneum. After the pneumoperitoneum was drained, another measurement was taken in the study group. While recruitment maneuver was applied to the study group after measurement, it was not applied to the control group and measurements were taken from both groups at the end of the operation . Room air test was performed in all patients in the recovery room. Results: Baseline FRK and static compliance values were similar in both groups. The primary aim of the study is; absolute differences of FRC and Static Compliance (Cs) measured at the beginning and end of the operation, respectively; ΔFRK T5-T1 p˂0,001, ΔCs T5-T1 p˂0,001. In the room air test performed to predict atelectasis is the secondary goal of the study; the room air test was positive in 2 patients (9%) in the study group, the room air test was positive in 5 patients (20%) in the control group. Although this does not make a statistically significant difference (p = 0.268), it makes a clinically significant difference. Conclusion: Application of alveolar recruitment maneuver prior to pneumoperitoneum in laparoscopic surgical procedures in healthy lungs provides statistically better static compliance values, whereas recruitment after pneumoperitoneum will provide statistically better functional residual capacity and better static compliance. Patients undergoing recruitment will experience less atelectasis clinically, although it is not statistically significant.