TITLE:
Effect of Rectus Plication during Abdominoplasty on the Mechanical Power and Airway Pressures: Comparison of Two Ventilatory Strategies
AUTHORS:
Sergio Soto-Hopkins, Hector Milla, Israel Espino-Gaucin
KEYWORDS:
Abdominoplasty, Mechanical Power (MP), Lung Pressures, General Anesthesia, Pressure Control Ventilation-Volume Guaranteed (PCV-VG), Volume Control Ventilation (VCV)
JOURNAL NAME:
Surgical Science,
Vol.13 No.7,
July
27,
2022
ABSTRACT: Background: Abdominoplasty is a commonly requested procedure for aesthetic
improvement of the affected soft tissue layers of skin, fat, and muscle through
the slightest incision feasible. The degree of plicature generates an increase
in intraabdominal pressure that causes an increase in intrathoracic pressure.
Pressure, volume, flow, and respiratory rate are components of a unique
physical variable, the mechanical power (MP), and is an integrated variable
linked to most factors related to postoperative pulmonary complications. Purpose: To assess the effect of rectus plication (RP) during abdominoplasty on lung
pressures and the contribution to increasing the MP. Method: A
open-label study was conducted at TJ Plast Advanced Center for Plastic Surgery
in Tijuana, México, from September 2021 to May 2022. The study included forty-six
female patients subjected to abdominoplasty or liposuction with abdominoplasty.
After the induction of general anesthesia and neuromuscular blockade, they were
allocated into two groups: Group 1 pressure control ventilation-volume
guaranteed (PCV-VG) and Group 2 volume control ventilation (VCV). Respiratory
pressures and MP were assessed before and after RP. Results: During VCV,
patients had a greater increase in peak pressure (PIP) (P 0.000). Plateau pressure
(Pplat) increased 1.78 ± 0.35
cmH2O in group 2 after RP (P = 0.001). MP had a greater increase in
group 2 after RP (P 0.01). Conclusion: This
prospective study showed that RP is related to an increase in PIP and Pplat and an increase in the MP better controlled with PCV-VG ventilation.