The Effects of Positive End-Expiratory Pressure at Different Levels on Postoperative Respiration Parameters in Patients Undergoing Laparoscopic Cholecystectomy

Purpose/Aim of the study: We investigated the effects of different positive end-expiratory pressure (PEEP) levels on postoperative respiration parameters in patients undergoing laparoscopic cholecystectomy. Materials and Methods: One hundred and five consecutive patients were randomly divided to three groups (n = 35, for each group). Group I did not receive PEEP whereas group II received PEEP as 5 cmH(2)O and group III received PEEP as 8cm H2O. Measurements with spirometer were taken 1hour before the operation (T-1) and, 1 (T-2), 6 (T-3), and 24hours (T-4) after extubation by an anesthetist. Forced expiratory volume (FEV1), forced vital capacity (FVC), and peak expiratory flow (PEF) were recorded. Results: Group I had higher FVC values measured at T-2 time point compared with other groups (p < 0.05, for both groups). There was a statistically significant difference between group I and group III in terms of the FVC values measured at T-3 and T-4 time points (p = 0.05 and p < 0.05, retrospectively). A statistical difference was found between group I and group II in terms of FEV1 measured at T-2 time point (p < 0.05). Group I had higher FEV1 values measured at T-3 and T-4 time points compared to group III (p = 0.05, P<0.05; respectively). Group III had lower PEF values measured at T-4 time point compared to group I and II (p < 0.05). Conclusions: We concluded that PEEP with 5 or 8 cmH(2)O has negative effects on lung function tests measured with spirometer during postoperative 1(st), 6(th), and 24(th) hours in patients underwent elective laparoscopic cholecystectomy.