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Volume 13 Issue 1 (January) 2024

Original Articles

Comparative study of respiratory dynamics using Pressure control volume guaranteed mode to conventional modes in elective robotic pelvic surgeries under general anesthesia
Dr. Apoorva Naik, Dr. Ankita Chaudhary, Dr. Shruthi A, Dr. Murugesan C

Background: With modern anaesthesia workstation, newer modes of ventilation like pressure controlled volume guaranteed mode (PCV VG) which combines the advantages of (VCV) volume control mode & (PCV) pressure control mode are being explored. Present study was aimed to compare respiratory dynamics using Pressure control volume guaranteed mode to conventional modes in elective robotic pelvic surgeries under general anesthesia.Material and Methods:Present study was single-center, prospective, randomized, open label study, conducted in adult patients(>18 years), belonging to ASA I and II of either sex undergoing elective robotic pelvic surgery under general anaesthesia, Patients were ventilated by VCV, PCV or PCV VG modes based on randomization.Results:Peak airway pressures in PCV & PCV VG modes remained comparable after 30minutesofpneumo-insufflationtilltheendofonehourofpneumo-insufflationindicating both PCV & PCV VG modes were equivocal at maintaining low peakairwaypressureunderpneumo-insufflationandlithotomywith Trendelenburg position.Dynamic compliance was high in PCV VG mode when compared to the conventionalmodes with statistically significant p values throughout the study period. A fall indynamic compliance was noted in all 3 modes in comparison to the baseline valuesduringpositioning and pneumo-insufflation.PCV VG mode delivered a higher tidal volume throughout the study period whencompared to conventional modes. This indicates that a better tidal volume with lowerpeak airway pressure was achievable with PCV VG when compared to conventionalmodes in our study settings.Conclusion:PCV VG mode which incorporates the innovation of delivering the preset tidal volume in a pressure regulated fashion can be advantageous over the conventional modes of ventilation under general anaesthesia in terms of ease of use, better tidal volume delivery, maintaining lower peak airway pressure & better intraoperative hemodynamics.

 
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