Effect of facemask ventilation with different ventilating volumes on gastric insufflation during anesthesia induction in patients undergoing laparoscopic cholecystectomy

OBJECTIVES: To compare the occurrence of gastric insufflation during anesthesia induction in patients undergoing laparoscopic cholecystectomy, using facemask ventilation with different ventilation volumes. METHODS: This is a prospective study of 54 patients undergoing laparoscopic cholecystectomy under general anesthesia between January 2018 and June 2018. Facemask ventilation with volume mode controlled at 6 ml/kg (group V6), 8 ml/kg (group V8) or 10 ml/kg (group V10) was applied for 120 seconds (sec) during anesthesia induction. Before facemask ventilation and at 120 sec of facemask ventilation, gastric insufflation was determined by ultrasonography. Gastric insufflation was also evaluated using direct vision of laparoscopy. Respiratory parameters were monitored. RESULTS: The incidence of gastric insufflation in group V10 (55.6%) was significantly higher than that in groups V6 (11.1%) and V8 (16.7%). However, it showed no significant difference between groups V6 and V8. During facemask ventilation for 120 sec, carbon dioxide accumulation trend occurred in group V6, and group V10 exhibited evidence of hyper-ventilation. Group V8 might be considered the best balance between low gastric insufflation and effective lung ventilation. CONCLUSION: Facemask ventilation with a ventilation volume of 8 ml/kg seems to have adequate preoxygenation and avoid excessive gastric insufflation during anesthesia induction in laparoscopic cholecystectomy.