Background: This study was designed to investigate the effects of inhaled anesthetic agents on respiratory
mechanics with low flow anesthesia in laparoscopic abdominal surgery. Two inhaled anesthetics,
desflurane and sevoflurane, have a lower solubility in blood and tissues than all previous
volatile anesthetics, and have become the preferred volatile anesthetics for routine surgical procedures.
Methods: Twenty-six patients were examined. Patients were randomly assigned to two groups, to
receive sevoflurane (n = 13) or desflurane (n = 13). Tidal volume and ventilation rate were kept
unchanged throughout the operation. Intra-abdominal pressure was kept constant at the level of 12
mm Hg. Respiratory mechanics such as peak inspiratory pressure (PIP), respiratory resistance (Rr),
and dynamic compliance (Cdyn) measurements were recorded by a Datex-Ohmeda respiratory device
(Datex-Ohmeda, Finland) at four timepoints: 5 minutes after mechanical ventilation started
(T1), after insufflation of the peritoneum (T2), in the 30-degree Trendelenburg position (T3), and
after desufflation of the peritoneum (T4).
Results: In our study, desflurane caused a statistically significant increase in PIP and Rr and decrease
in Cdyn. When the two groups were compared, Rr values in the deslurane group showed significant
increases at T2, T3, and T4 compared to the sevoflurane group (P < 0.05). These values did
not change in the sevoflurane group, while PIP significantly increased at T2, T3, and T4 after desufflation
in the desflurane group (P < 0.05). Cdyn values decreased significantly at all 4 timepoints in
the desflurane group compared to the sevoflurane group (P < 0.05).
Conclusion: We concluded that respiratory mechanics were affected by desflurane with low flow
anesthesia in patients undergoing laparoscopic abdominal surgery. No significant influence on respiratory
mechanics was seen with sevoflurane anesthesia.
