Comparison of Intra-operative Pressure-Controlled Ventilation and Volume-Controlled Ventilation in Bariatric Surgery: A Prospective Randomized Study

Mehmet Salih Sevdi; Serdar Demirgan; Kerem Erkalp; Melahat Karatmanlı Erol; Ali Ozalp; Yuksel Altinel; Aysin Alagol

doi:10.7759/cureus.17567

Comparison of Intra-operative Pressure-Controlled Ventilation and Volume-Controlled Ventilation in Bariatric Surgery: A Prospective Randomized Study

Cureus. 2021 Aug 30;13(8):e17567. doi: 10.7759/cureus.17567. eCollection 2021 Aug.

Authors

Mehmet Salih Sevdi¹, Serdar Demirgan¹, Kerem Erkalp², Melahat Karatmanlı Erol¹, Ali Ozalp¹, Yuksel Altinel³, Aysin Alagol¹

Affiliations

¹ Department of Anesthesiology, Bağcılar Training and Research Hospital, University of Health Sciences, Istanbul, TUR.
² Department of Anesthesiology, Istanbul University-Cerrahpaşa Institute of Cardiology, Istanbul, TUR.
³ Department of General Surgery, Bağcılar Training and Research Hospital, University of Health Sciences, Istanbul, TUR.

Abstract

Background: Mechanical ventilation may be particularly challenging in obese patients undergoing laparoscopic bariatric surgery. The present study aimed to compare the effects of pressure-controlled ventilation (PCV) with those of volume-controlled ventilation (VCV) on peripheral tissue oxygenation (PTO), respiratory function, hemodynamic status, and ventilation-related complications in patients undergoing laparoscopic bariatric surgery.

Methods: A total of 100 patients with obesity who underwent gastric plication or sleeve gastrectomy were recruited for the study, and 60 patients (n=32, in group PCV; n=28, in group VCV) were ultimately enrolled. Data on peri-operative PTO (arterial blood gas [ABG] analysis and tissue oxygen saturation [StO₂]) and respiratory functions were recorded for each patient, along with post-operative hemodynamic status, fluid intake, urinary output, Numeric Pain Rating Scale (NPRS) score , and complications.

Results: The two groups were similar in pH, partial pressure of oxygen, partial pressure of carbon dioxide, oxygen saturation, and lactate values at baseline, intra-operative and post-operative periods. The peri-operative StO₂ values were also similar between the two groups at all times. The two groups were identical in terms of preoperative values for respiratory function tests and post-operative hemodynamic status, fluid intake, urinary output, pain scores, and complication rates.

Conclusions: In conclusion, the choice of the mechanical ventilation mode did not appear to influence oxygen delivery, respiratory function, hemodynamic status, post-operative pain, or ventilation-related complications in obese patients undergoing laparoscopic bariatric surgery.

Keywords: bariatric surgery; general anesthesia; obesity; peripheral tissue oxygenation; pressure-controlled ventilation; volume-controlled ventilation.