Comparison of Transcutaneous, Arterial and End-tidal Measurements of Carbon Dioxide during Laparoscopic Cholecystectomy in Patients with Chronic Obstructive Pulmonary Disease

Objective: Transcutaneous, arterial and end-tidal measurements of carbon dioxide were compared in patients (American Society of Anesthesiology physical status classes II and III) with chronic obstructive pulmonary disease (COPD) who underwent laparoscopic cholecystectomy with carbon dioxide insufflation. Methods: General anaesthesia was performed in all patients. The Sentec® system was used for transcutaneous monitoring of the partial pressure of carbon dioxide (TcPCO2). TcPCO2 and arterial partial pressure of carbon dioxide (PaCO2) were recorded preoperatively, after induction of anaesthesia, during insufflation and postoperatively; end-tidal carbon dioxide (ETCO2) was recorded after induction and during insufflation. Results: PaCO2 increased during insufflation and reached a maximum at extubation. It declined within 20 min postoperatively but did not return to preoperative levels during this time. TcPCO2 levels followed a similar pattern. ETCO2 was significantly lower than PaCO2 after induction and during insufflation. Conclusion: TcPCO2 was a valid and practical measurement compared with ETCO2. In patients with COPD undergoing laparoscopic cholecystectomy, TcPCO2 and ET could be used instead of arterial blood gas sampling.