Metabolic gas exchange during gynaecological laparotomy and laparoscopy.

The purpose of this study was to evaluate metabolic gas exchange change during surgery performed with general anaesthesia. Metabolic gas exchange was measured continuously (Deltatrac) during 33 gynaecological laparotomies and 22 laparoscopies performed during anaesthesia with propofol, fentanyl and vecuronium in mechanically ventilated patients. In both groups of patients, oxygen consumption (VO2) increased rapidly after skin incision (5-8% after 5 min, P < 0.01) and further increased during the surgical procedure (7% at 15 min in the laparoscopy group, P < 0.001 and 15% at 60 min in the laparotomy group, P < 0.0001). Carbon dioxide production (VCO2), on the other hand, showed different patterns in the two groups. It is concluded that a dynamic development of VO2 was seen during surgery suggesting that continuous measurement of VO2 might be used to evaluate the metabolic response evoked by surgical intervention.