Application of PRVC in laparoscopic surgery

Xiaguang Duan, Zaiqing Huang, Chunguang Hao, Xiaojun Zhi, Xiaobing Qi, Ling Ren, Shenghui Luan, Chengguang Liang


Objective: To discuss the clinical significance and value of PRVC by monitoring, comparing and studying pressure control (PC), volume control (VC) and pressure-regulated volume control (PRVC) ventilation modes during pneumoperitoneum.

Methods: Ninety patients with laparoscopic cholecystectomy were randomly and equally divided into 3 groups (PC group, VC group and PRVC group). Esophageal pressure (PES), mean airway pressure (PAWM), peak airway pressure (PAP), arterial blood carbon dioxide partial pressure (PaCO2), end-tidal carbon dioxide concentration in the expired air (ETCO2), tidal volume (TV), mean arterial pressure (MAP) and heart rate (HR) were not only detected before pneumoperitoneum, but also in 5, 10, 15 and 20 minutes after pneumoperitoneum.

Results: PES after pneumoperitoneum in VC mode was obviously higher than that in PC and PRVC groups. In 10 minutes after pneumoperitoneum, levels of PaCO2 and ETCO2 became increased obviously in PC and VC groups (p < .05); levels of PaCO2 and ETCO2 were not only increased in PC group, but also the level of TV after pneumoperitoneum in PC group was significantly lower than that in the other two groups (p < .05). Levels of PaCO2 and ETCO2 were increased in PC and VC groups after pneumoperitoneum, along with the increase of MAP and HR (p < .05). After pneumoperitoneum, levels of MAP and HR in PRVC group were significantly lower than those in PC and VC groups (p < .05).

Conclusions: PRVC mode can effectively reduce the pneumoperitoneum-induced increase of PAWM, PAP and PES without the unusual increase of PaCO2 and ETCO2 during surgery, so as to guarantee the stability of vital signs in perioperative patients.

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Discussion of Clinical Cases  ISSN 2375-8449(Print)  ISSN 2375-8473(Online)

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