Use of positive pressure in preoperative and intraoperative of bariatric surgery and its effect on the time of extubation

BACKGROUND AND OBJECTIVE:

To investigate the influence of intraoperative and preoperative positive pressure in the time of extubation in patients undergoing bariatric surgery.

METHOD:

Randomized clinical trial, in which 40 individuals with a body mass index between 40 and 55 kg/m², age between 25 and 55 years, nonsmokers, underwent bariatric surgery type Roux-en-Y gastric bypass by laparotomy and with normal preoperative pulmonary function were randomized into the following groups: G-pre (n = 10): individuals who received treatment with noninvasive positive pressure before surgery for 1 h; G-intra (n = 10): individuals who received positive end-expiratory pressure of 10 cm H₂O throughout the surgical procedure; and G-control (n = 20): not received any preoperative or intraoperative intervention. Following were recorded: time between induction of anesthesia and extubation, between the end of anesthesia and extubation, duration of mechanical ventilation, and time between extubation and discharge from the post-anesthetic recovery.

RESULTS:

There was no statistical difference between groups. However, when applied to the Cohen coefficient, the use of positive end-expiratory pressure of 10 cm H₂O during surgery showed a large effect on the time between the end of anesthesia and extubation. About this same time, the treatment performed preoperatively showed moderate effect.

CONCLUSION:

The use of positive end-expiratory pressure of 10 cm H₂O in the intraoperative and positive pressure preoperatively, influenced the time of extubation of patients undergoing bariatric surgery.

Diseases; Obesity; Bariatric surgery; Ventilation