Application Of Blood Gas Analysis In Laparoscopic Operation Of Obesity Patients With Type2Diabetes

Objective To evaluate the clinical application value of arterial blood gasanalysis on obesity patients with type2diabetes during laparoscopicsurgery under general anesthesia．Methods16cases of obesity patients with type2diabetes, ASAâ…¡-â…¢, underwent selective laparoscopic Roux-en-Y gastrojejunostomybypass surgery under general anesthesia．The values of MAP，HR，SpO2,PIP and PETCO₂were recorded before anesthesia （T0）,beforeinsufflation（T1）,30min after insufflation （T2）、1.5h（T3）、2.5h （T4） and3.5h （T5）,30min after deflation（T6）,After operation30min （T7）.At thesame time,arterial blood samples were taken for gas analysis and the dataof PaO2,SaO2,PaCO₂,pH,BE and Glu were recorded. Pa-ETCO₂werecalculated.Results After insufflation，HR in a trend of increase,but had nosignificant change（P>0.05）.The values of MAP decreased after inductionand presented a tendency of increase after insufflation,T4、T5weresignificantly higher than T1（P<0.05）,after delation，MAP decreased butwere still higher than T1（P<0.05）,T7had recovered the level of beforeanesthesia.After insufflation, PIP were obviously higher than beforeinsufflations（P<0.05）. After insufflation,PaO2in T2, T3were significantlylower than T1（P<0.05）, but with a gradual increase in pneumoperitoneumduration, SpO2and SaO2hadn’t no statistical significance（P>0.05）.PETCO₂、PaCO₂and Pa-ETCO₂appeared the rising trend with the extension of pneumoperitoneum time after insufflation, T4、T5increasedsignificantly comparing with T1（P<0.05），30min after the deflation werestill higher than before pneumoperitoneum（P<0.05）,30min afteroperation had recovered the level of before anesthesia. afterpneumoperitoneum, pH and BE decreased gradually with the extension ofpneumoperitoneum time, but had no statistical significance （P>0.05）.Blood glucose increased after anesthesia and increased with the time ofoperation （P>0.05）.Conclusion obesity patients with type2diabetes who receivedlaparoscopic Roux-en-Y gastrojejunostomy bypass surgery have a greatimpact on arterial blood gas analysis during the pneumoperitoneum,PaCO₂can reflect the real level of carbonate in the body better thanPETCO₂, the application of blood gas analysis in such the operation is ofgreat significance.