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| Use of Laryngeal Mask Combined with Pressure-controlled Inverse Ratio Ventilation in Gynecological Laparoscopy |
| Jiaozhou Central Hospital， Qingdao 266300， China |
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Abstract Objective：To investigate the effect of pressure-controlled inverse ratio ventilation using laryngeal mask airway in gynecological laparoscopy.Method：Thirty patients between 18 and 60 years， American Society of Anesthesiologists class 1-3， scheduled for elective major gynecological laparoscopy were included in the study.Size 4 flexible LMAs were used for patients.Pressure-controlled ventilation（ PCV） was initiated with tidal volume 8 mL/kg，
inspiratory–expiratory（ I：E） ratio was kept 1：2， with positive end expiratory pressure（ PEEP） of 5 cm H2O.Intraoperative monitoring included noninvasive blood pressure， pulse oximetry， end-tidal carbon dioxide， 5-lead EKG，gas monitoring.After 15 min of pneumoperitoneum readings were recorded.I：E ratio was now changed to 1.5：1 on the mode PCV（ PCIRV） and PEEP of 5 cm H2O continued.Readings were taken after 15 min of PCIRV.Result：The peak and plateau pressures after pneumoperitoneum during PCV was（ 25.5±3.67） and（ 25.35±3.8） cm H2O， respectively
and during PCIRV（ 25.8±3.86） and（ 25.8±3.41） cm H2O， respectively， and was statistically similar.The mean airway pressure during PCV（ 13.5±1.35） cm H2O was lower than PCIRV（ 17.30±2.08） cm H2O（ P<0.01）.Tidal volume on PCIRV（ 502±49.19）mL was significantly higher as compared to PCV（ 450±38.25） mL.The dynamic compliance on PCIRV（ 24.8±4.25）mL/cm H2O was also significantly higher than PCV（ 21.50±3.9）mL/cm H2O.Conclusion：PCIRV with I：E ratio 1.5：1 can be an effective mode of ventilation in major gynecological laparoscopy using LMA.
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