The Effects of Different End Tidal CO2 Values on Hemodynamics and Surgery in Endoscopic Endonasal Transsphenoidal Pituitary Surgery.

Objective: We aimed to examine the effect of different intervals of end tidal CO2 (etCO2) values on hemodynamics and surgery in endoscopic endonasal transsphenoidal pituitary surgery. Material and Methods: Two groups were evaluated retrospectively according to the maximum etCO2 values at the time of mass sellar resection. Group 1: 21 patients, etCO2 =25-37 mmHg and Group 2: 21 patients, etCO2=38-50 mmHg. The demographic characteristics, mean arterial pressure (MAP), heart rate (HR), etCO2, arterial CO2 pressure (PaCO2) at the time of anesthesia induction, sellar excision moment and pre-extubation periods, total amount of bleeding, ease of surgery (good-moderate-bad) were obtained from computer records, anesthesia receipts and surgical reports. Results: There was no difference between the two groups in terms of demographic data, complications or bleeding. A significant relationship was found between PaCO2 values of two groups at the time of sellar excision. Surgical satisfaction was evaluated as "good" in 9 patients in Group 1 and 12 patients in Group 2. Conclusion: High etCO2 values (38-50 mmHg) facilitated surgical excision of the mass and did not affect hemodynamics. Surgery satisfaction has increased. Keeping etCO2 slightly higher than normal may be a good choice in these cases. Well-designed prospective studies are needed. [ABSTRACT FROM AUTHOR]