The effects of different pneumoperitoneum pressures on middle ear pressure and frequency of postoperative nause-vomiting in laparoscopic cholecystectomy

This study aimed to show the effects of different CO2 pressures used in PN for patients scheduled for elective laparoscopic cholyscectomy on middle ear pressure and postoperative nausea and vomiting.The study was conducted on 60 patients in risk groups of ASA I-II who were scheduled for laparoscopic cholyscectomy. One day before the operation, both ears of the patients were examined with an autoscope. Anesthesia was induced in both groups with 5-7 mg kg?1 tyopental sodium and 0.2 µg kg-1 min-1 remifentanil infusion, and after 0.6 mg kg?1 rocuronium bolus, endotracheal intubation was realized. Anesthesia was maintained by remifentanil (0.05-0,3 µg kg?1 min?1) infusion in both groups, and inhalation anesthesia was made using isoflurane. The patients were ventilated with 40% oxygen/air mixture at 4 lt min?1, frequency of 12 min?1 and tidal volume of 8 ml kg?1. The rates of HR, MAP, SpO2, MEP 1 and MEP 2 values were recorded before the induction. After the induction, intubation, PN formation, and positioning of the patient 3., 6., 9., 15., 20. and after the completion of the pressure, while the patients were in the supine position, these parameters, EtCO2, and inspiratory isoflurane values were recorded. At the postoperative 5th, 10th, and 30th minutes, MEP 1, MEP 2, VAS, VDS, and the amount of metoklopramid administered were recorded. In the postoperative 24 hours, the scores of VDS scale, total amount of metoklopramid, and the time of administration were recorded.In conclusion, no statistically significant differences were found between the two groups that were applied low PN pressure (8-10 mmHg) and high PN pressure (13-15mmHg) for MEP. In the postoperative 12-24 hours, the rate of PONV was high in Group D. of these patients, 7 were young and female, which indicated PONV was more common in the young and female individuals.A statistically significant difference was found in the intragroup comparisons for MEP: During induction, in the right and left ears in both groups; after intubation, in the left ear in both groups; and in Group Y, in the right ear. These findings were supportive of the hypothesis that ventilation with a mask and volatile anesthetic agents increase MEP. After the patients in both groups were positioned, the values of MEP decreased in both the right and left ears.