PaO2 may decrease during laparoscopy for several pneumoperitoneum-related causes, such as decreased cardiac output, worsened ventilation-perfusion mismatch, decreased alveolar ventilation, acidosis, venous gas embolism, and pneumothorax (178). Clinical studies revealed a slight but clinically insignificant reduction of PaO2 during laparoscopy (21,39,44,62,102). Although one group reported a less than 100 mmHg drop in PaO2 during N2O laparoscopy in two patients with heavy smoking history (179), others have found PaO2 during laparoscopy to be unaffected significantly by preoperative pulmonary status (62).

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