Study of arterial blood gas changes in patients undergoing abdominal hernia repair surgery
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Abstract
Aim — Background
Abdominal wall hernia repair surgery is one of the most common procedures performed worldwide. Apart from the aesthetic effect that it has on the human body, it also leads to an increase in intra-abdominal pressure in the immediate postoperative period, which tends to normalize in the later postoperative period. The aim of our project is to study the arterial blood gas changes that occur due to the intra-abdominal pressure difference and its consequent effects on the respiratory mechanics, given the fact that all other parameters are standardized.
Patients-Methods
Arterial blood gas changes were studied preoperatively, at the 1st and 8th postoperative day in 50 patients with inguinal hernia, 36 patients with umbilical hernia and 30 patients with postoperative hernia that underwent abdominal wall hernia repair surgery. All the patients in our study were operated for hernia of medium or large size (containing omentum and part of intestine), had normal temperature, suffered no blood loss during the operation and were in no need of blood transfusion, had the same anaesthetic parameters, and were pain-free. Measurements were made under the same standardized procedures. Patients with respiratory system and cardiovascular diseases were excluded. The statistical analysis used for measurements of blood gas changes was the paired samples t-test; the normality of the distributions was checked by the Kolmogorof-Smirnov test.
Results
In our series, we observed that on the 1st postoperative day, pH increased (0.36%); pO2 increased (1.181%); pCO2 decreased (8.96%); HCO3 decreased (2.778%); SO2 increased (0.19%); BE decreased (1.16%). On the 8th postoperative day, pH increased (0.35%); pO2 increased (4.311%); pCO2 increased (7.0122%); HCO3 decreased (1.11%); SO2 increased (0.8212%); BE increased (30.2%). The changes observed between 1st and 8th postoperative day were as follows: pH showed no noticeable change; pO2 increased (3.1%); pCO2 increased (2.142%); HCO3 increased (1.72%); SO2 increased (0.63%); BE increased (31.725%).
Conclusion
Abdominal wall hernia repair surgery leads to an increase in the intra-abdominal pressure in the immediate postoperative period, which tends to normalize in the later postoperative period. According to our study, this intra-abdominal pressure difference has consequent effects on the respiratory mechanics and leads to arterial blood gas changes
Key words
Abdominal hernia repair Arterial blood gas changesPreview
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