Gastric Insufflation and Ventilatory Mode during Induction of Anesthesia: A Prospective Randomized Study

Abstract

Mechanical ventilation is a fundamental tool in daily anesthetic practice. Several ventilation modes are used for the ventilation of patients during the induction of general anesthesia; the controlled volume mode is most commonly used by anesthesiologists. Ventilation often causes gastric insufflation, which may be responsible for gastric fluid inhalation, with serious consequences. The aim of our study was to compare the incidence of gastric insufflation according to the ventilatory mode used during anesthesia induction. Methods: This was a randomized prospective study carried out in the central operating complex of the Mohamed V Military Teaching Hospital in Rabat for a period of 06 months between January and June 2021. The patients included in our study were candidates for laparoscopic cholecystectomy. Gastric insufflation was assessed using epigastric auscultation. Finally, it is evaluated using the camera. Results: During the study period, 120 patients were enrolled and divided into three groups of 40 patients according to the ventilation mode used: Group VM (Manual Mode), Group VV (Controlled Volume Mode) and Group VP (controlled pressure Mode). There were no statistically significant differences between the three groups in terms of hemodynamic and respiratory parameters. Gastric insufflation rate was lower in the VP group (14%). The pressure-controlled ventilation mode causes less gastric insufflation without additional hemodynamic or respiratory cost and gives the surgeon greater comfort without the need for a stomach probe.