ENES USLU, ENGİN IHSAN TURAN, AYÇA SULTAN ŞAHİN
Comprehensive Medicine - 2025;17(1):36-43
Objective: Obesity is a chronic, multisystemic disease associated with various comorbidities, complicating anesthesia management. This study compares the effects of pressure control ventilation (PCV) and volume control ventilation (VCV) on hemodynamic, respiratory, and blood gas parameters in patients undergoing sleeve gastrectomy. Materials and Methods: This randomized, prospective, single-blinded study included 44 patients aged 1865 years with a BMI>40 kg/m² (ASA III). Patients were randomly divided into two groups to receive either PCV or VCV during the operation. Key parameters, such as heart rate, mean arterial pressure, peak and plateau pressures, PEEP, lung compliance, and arterial blood gas values, were measured at regular intervals. PEEP adjustments were made according to oxygenation needs, and end-tidal CO2 (EtCO2 ) levels were continuously monitored, with adjustments made to maintain EtCO2 within the target range of 3040 mmHg. Results: Heart rate, mean arterial pressure, peak and plateau pressures, and lung compliance were similar between PCV and VCV groups. PCV showed higher PEEP at 45 and 75 minutes, lower pH at 45 minutes, and higher PaCO2 at 45 minutes. Lactate levels showed no differences across time points. Conclusion: Both PCV and VCV maintain stable hemodynamic and respiratory conditions in obese patients undergoing sleeve gastrectomy, with PCV showing higher PEEP levels and transient differences in pH and PaCO2 . These findings indicate that both PCV and VCV are effective ventilation methods for sleeve gastrectomy. However, individualized patient management and close monitoring of ventilation parameters remain essential.
