Fig 1.
Diaphragmatic excursion as measured using 2D mode sonography.
With the probe fixed on the right midaxillary line at approximately the sixth to ninth intercostal spaces, the ultrasound beam was directed to the hemidiaphragmatic domes at an angle of about 70 degrees. The diaphragm (white arrow) is located cephalad to the liver <asterisk>.
Fig 2.
M-mode sonography of diaphragmatic excursion.
The amplitude of excursion (red arrow) was measured on the vertical axis of the tracing from the baseline to the point of maximum height of inspiration.
Table 1.
Demographic and perioperative characteristics of the study patients.
Table 2.
Pulmonary variables during the operation.
Fig 3.
Diaphragmatic excursions at each surgical time point.
Diaphragmatic movement was decreased gradually during operation. Diaphragmatic excursion had the largest drop 90 minutes after Trendelenburg position with pneumoperitoneum (T2) compared to after sedation (T0, P < 0.001). T0 = after sedation (bispectral index < 60, train-of-four (TOF) ratio > 0.9); T1 = after the intubation (bispectral index < 60, TOF ratio = 0); T2 = 90 minutes after Trendelenburg position with pneumoperitoneum; T3 = after operation with recovery of muscle relaxation under mechanical ventilation (bispectral index < 60, TOF ratio > 0.9).