Endoscopic surgical procedure has recently been applied to not only intraabdominal or intrathoracic surgery but also saphenous vein harvesting, because it is less invasive and more cosmetically advantageous. Carbon dioxide insufflation during an endoscopic saphenous vein harvesting may cause an adverse effects on arterial blood gas and hemodynamic variables. This study was conducted to evaluate the safety of carbon dioxide insufflation during endoscopic saphenous vein harvesting.

Patients in ASA physical status III or IV, scheduled for an endoscopic saphenous vein harvesting (n=30) were gathered for the evaluation. Until the end of the procedure, controlled mechanical ventilation (tidal volume: 10 ml/kg, respiratory rate: 10 rates/min) and ventilator mode was fixed in this tidal volume and respiratory rate. Arterial blood gas analysis, end-tidal carbon dioxide, blood pressure and heart rate were measured before and at 10, 20, 30, 40 minutes after carbon dioxide insufflation.

Preinsufflation values of PaCO₂ (partial pressure of arterial carbon dioxide) and P_ETCO₂ (partial pressure of end-tidal carbon dioxide) were 33.4 ± 3.6 mmHg and 24.1 ± 4.1 mmHg, respectively. PaCO₂ was significantly increased at 30 and 40 minutes after carbon dioxide insufflation (40.1 ± 7.4 mmHg and 41.4 ± 8.6 mmHg). P_ETCO₂ was significantly increased at 20, 30 and 40 minutes after carbon dioxide insufflation(27.6 ± 5.5 mmHg, 28.9 ± 7.0 mmHg and 29.6 ± 7.8 mmHg). But, the magnitude of difference between PaCO₂ and P_ETCO₂ was not significantly different.

During endoscopic saphenous vein harvesting, PaCO₂ was significantly increased compared with preinsufflation values. Careful monitoring of PaCO₂ is mandatory during the procedure.