Anesthetic management during laparoscopic ovariectomy without positive ventilation: Report of two cases

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Koliou E. DVM, Intern, Anaesthesia and Critical Care Unit, School of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece | Varkoulis K. DVM, MSc, resident ECVAA, School of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece | Ververidis C. DVM, PhD, Professor of Obstetrics and Physiopathology of Reproduction of Companion Animals, Companion Animal Clinic, School of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece | Kazakos G. DVM, PhD, Professor, Clinic of Surgery - Anaesthesia and Intensive Care Unit, School of Veterinary Medicine, University of Thessaloniki, Thessaloniki, Greece

Introduction

During laparoscopic surgery, CO₂ is insufflated into the peritoneal cavity and the intra-abdominal pressure is increased up to 15 mmHg, which renders positive ventilation necessary during the operation. The aim of this study is to report two cases of dogs that underwent laparoscopic ovariectomy, during which positive ventilation was not required.

Materials and methods

The study reported two cases of female dogs, presented for elective laparoscopic ovariectomy. The preoperative clinical examination found to be normal. The anaesthetic protocol included dexmedetomidine, tramadol, meloxicam, propofol and isoflurane in 100% O₂. Electrocardiography, oximetry, capnography, invasive arterial blood pressure and arterial blood gases were used for monitoring. CO₂ insufflation into the abdominal cavity was adjusted so that the intra-abdominal pressure did not exceed 5mmHg.

Results

The end-tidal CO₂ did not change when the insufflation was applied, the tidal volume was 16ml/kg to 14ml/kg, the oxygen saturation was within normal limits, while an increase in mean arterial blood pressure of 20 mmHg was observed. It is worth to note that the surgical conditions were reported as completely satisfactory.

Conclusions

It is possible to preserve sufficient spontaneous minute ventilation by applying an intrabdominal CO₂ insufflation pressure of up to 5 mmHg during laparoscopic ovariectomy.