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The effect of mechanical ventilation tidal volume during pneumoperitoneum on shoulder pain after a laparoscopic appendectomy

机译：气腹中机械通气潮气量对腹腔镜阑尾切除术后肩痛的影响

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摘要

Background Postlaparoscopic shoulder pain (PLSP) frequently occurs after various laparoscopic surgical procedures. Its mechanism is commonly assumed to be overstretching of the diaphragmatic muscle fibers due to the pressure of a pneumoperitoneum, which causes phrenic nerve-mediated referred pain to the shoulder. Based on this hypothesis, we speculated that during inspiration, the lung could squeeze out the phrenic nerve with carbon dioxide gas against the constantly pressurized abdominal cavity with increasing tidal volume (VT). Thus, we examined whether mechanical ventilation with a low VT (LTV, VT 7 ml/kg) during a pneumoperitoneum might reduce PLSP in patients undergoing laparoscopic appendectomy compared with ventilation with the traditional VT (TTV, VT 10 ml/kg).
机译：背景各种腹腔镜手术程序后，经常发生腹腔镜后肩痛（PLSP）。通常认为其机制是由于气腹膜的压力导致diaphragm肌纤维过度伸展，从而导致神经介导的肩部疼痛。基于此假设，我们推测在吸气过程中，随着潮气量（V T ）的增加，肺部可以通过二氧化碳气体将the神经挤出到不断加压的腹腔。因此，我们检查了在腹腔镜阑尾切除术患者气腹期间进行低V T （LTV，V T 7 ml / kg）机械通气是否可以减少PLSP使用传统的V T （TTV，V T 10 ml / kg）。

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