Haemodynamic effects of pneumoperitoneum and the influence of posture during anaesthesia for laparoscopic surgery
| Autor: | Martin Bäckdahl, A. von Rosen, S. Odeberg, P. Gannedahl, T. Svenberg, Olle Ljungqvist, Alf Sollevi |
|---|---|
| Rok vydání: | 1994 |
| Předmět: |
Adult
Male Increased pulmonary capillary wedge pressure Insufflation Mean arterial pressure Adolescent Central Venous Pressure Posture Blood Pressure Pulmonary Artery Pneumoperitoneum Afterload Heart Rate Tidal Volume Ventricular Pressure medicine Humans Pulmonary Wedge Pressure Cardiac Output Cardiopulmonary disease business.industry Respiration Hemodynamics Central venous pressure General Medicine Carbon Dioxide Middle Aged medicine.disease Oxygen Preload Anesthesiology and Pain Medicine Cholecystectomy Laparoscopic Anesthesia Anesthesia Intravenous Female Vascular Resistance business Pneumoperitoneum Artificial |
| Zdroj: | Acta Anaesthesiologica Scandinavica. 38:276-283 |
| ISSN: | 1399-6576 0001-5172 |
| DOI: | 10.1111/j.1399-6576.1994.tb03889.x |
| Popis: | The laparoscopic operating technique is being applied increasingly to a variety of intra-abdominal operations. Intra-abdominal gas insufflation, i.e. pneumoperitoneum (PP), is then used to allow surgical access. The haemodynamic effects of PP in combination with different body positions have not been fully examined. Eleven patients without signs of cardiopulmonary disease were studied before and during laparoscopic cholecystectomy under propofol-fentanyl anaesthesia with controlled ventilation. Swan-Ganz and radial arterial catheterization were used to determine haemodynamic data in the horizontal position, with a 15-20 degree head-down tilt and a 15-20 degree head-up tilt. The measurements were repeated after insufflation of carbon dioxide to an intraabdominal pressure of 11-13 mmHg, as well as during surgery. The ventricular filling pressures of the heart were strictly dependent on body position. PP in the horizontal position increased pulmonary capillary wedge pressure by 32% (P < 0.01), central venous pressure by 58% (P < 0.01), and mean arterial pressure by 39% (P < 0.01). When PP was combined with a head-down tilt, there was a further increase in filling pressures by approximately 40% (P < 0.01), while the reduction in filling pressures during the head-up tilt was counteracted by PP. During PP with a head-up tilt, the filling pressures did not differ from those in the horizontal position without PP. CI showed a certain dependency on filling pressures. It is concluded that PP causes signs of elevated preload and afterload. The combination of PP and a head-up tilt is associated only with signs of an elevated afterload.(ABSTRACT TRUNCATED AT 250 WORDS) |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text