Effects of two different ventilation strategies on respiratory mechanics during robotic-gynecological surgery.

It is unknown which is the best ventilatory approach in patients scheduled for gynecological robotic surgery in Deep Trendelenburg position in terms of respiratory mechanics. 40 patients were enrolled: 20 patients received a standard ventilation and 20 patients received a protective ventilation. Gas exchanges, respiratory mechanics and hemodynamic parameters were recorded. No significant differences were found between the two groups in terms of respiratory mechanics. In both groups, there was a significant reduction of static compliance between Baseline and Extubation Time (p < 0.01), and a significant increase of pulmonary pressure at the same times (p < 0.01). In both groups, a significant reduction of pH (p < 0.01) and a significant increase of PaCO2 (p < 0.01) were observed between Baseline and Extubation Time. At the Extubation time, PaCO2 was significantly higher during protective ventilation compared to standard ventilation. In this particular surgical setting, a protective ventilation strategy did not improve the respiratory mechanics compared to the standard ventilation strategy and was ineffective on post-operative gas exchanges.