Ultrasound for Postop Lung Issues in Low-Flow Anesthesia

Postoperative atelectasis is a common complication that can develop in all patients receiving general anesthesia. The frequency of atelectasis increases due to increased intraabdominal pressure, especially in laparoscopic surgeries performed with pneumoperitoneum. For this reason, in order to prevent postoperative complications related to the lungs, it is extremely important to recognize atelectasis at an early stage, as well as to recognize the mechanisms that will cause atelectasis and avoid them.

Lung ultrasonography (Lung USG) draws attention for the rapid, cheap, safe and reliable detection of postoperative atelectasis. The fact that it can be applied at the bedside and can be easily repeated makes this method valuable. In the literature and in daily practice, it is seen that anesthesiologists commonly apply inhalation anesthesia with different fresh gas flow (FGF) rates during general anesthesia.

As defined by Baker and Simionescu, in low-flow anesthesia, FGF varies between 0.5 and 1 liter per minute. It has been shown that all types of flow are safe with modern anesthesia machines.

This study aims to demonstrate the effect of low-flow anesthesia (LFA) on pulmonary complications and, in particular, atelectasis that may develop after laparoscopic cholecystectomy operations, using a non-invasive, rapidly applicable, and proven method such as Lung USG.

Inclusion criteria

• Patients with informed consent
• Patients scheduled for laparoscopic cholecystectomy
• Patients with a Body Mass Index between 18-35 kg/m²
• Patients in the American Society of Anesthesiologist (ASA) 1-2-3 category

Exclusion criteria

• Patients with emergency surgery planned
• Patients with ASA 4 and above
• Patients with lung disease
• Patients who have undergone thoracic surgery
• Pregnancy
• Patients with a preoperative Lung Ultrasound Score of 2 or 3 in any lung region