Objective:

To evaluate the correlation between airway pressure (PIP and PLAT) and intra-abdominal pressure (IAP) during laparoscopic cholecystectomy and to determine the diagnostic accuracy of AWP for detecting intraoperative IAH.

Approach:

• Study Design: Prospective, observational, cross-sectional study conducted at Hospital Geral de Goiânia, Brazil, from January 2020 to December 2021.
• Patient Selection: Patients aged up to 60 years with symptomatic cholelithiasis, ASA physical status I or II, were included. Exclusions were made for clinical decompensation or incomplete data.
• Anesthetic and Ventilatory Protocol: Balanced general anesthesia was used with standardized ventilatory parameters, ensuring no confounding positional changes during measurements.
• Airway Pressure Measurements: PIP and PLAT were recorded from a multiparametric anesthesia monitor during pneumoperitoneum at incrementally increased IAP levels.
• Statistical Analysis: Linear mixed-effects model (LME) was used to analyze the association between IAP and AWP, with Pearson correlation coefficients calculated.

Key Findings:

• Data were complete for 78 patients across five measurement points, yielding 390 IAP–AWP pairs.
• A correlation between AWP and IAP during laparoscopic procedures was established.
• The study assessed the diagnostic accuracy of AWP for detecting intraoperative IAH.

Interpretation:

Limitations:

• The study was conducted in a single center, which may limit generalizability.
• The sample size, while calculated for power, may still be insufficient for broader conclusions.
• No sensitivity analyses were prespecified.

Conclusion:

Airway pressure measurements could provide a practical alternative for monitoring intra-abdominal pressure during laparoscopic surgeries.