Systematic evaluation of different approaches for minimizing hemodynamic changes during pneumoperitoneum

Junghans, T.; Modersohn, D; Dörner, F; Neudecker, Jens; Haase, Oliver; Schwenk, W.

doi:10.1007/s00464-004-2231-2

Cited by 19 publications

(15 citation statements)

References 23 publications

(23 reference statements)

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“…Due to the harmful effects of elevated IAP, it is recommended that the lowest IAP possible be used, allowing adequate exposure of the operative field, rather than a standard pressure [17]. To counteract diminished organ perfusion and decreased cardiac function, generous volume loading is recommended [8,17]. To minimize these harmful effects, we used a low IAP (8)(9)(10)(11)(12) for patients with pneumoperitoneum.…”

Section: Discussionmentioning

confidence: 98%

Laparoscopic cholecystectomy with carbon dioxide pneumoperitoneum is safe even for high-risk patients

et al. 2007

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Section: Discussionmentioning

confidence: 98%

Laparoscopic cholecystectomy with carbon dioxide pneumoperitoneum is safe even for high-risk patients

et al. 2007

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“…In a previous manuscript, we have already shown that an increased ITBV improves hemodynamic function in all body positions during PN [6]. The selective β-blocker esmolol reduced cardiac output and myocardial contractility.…”

Section: Discussionmentioning

confidence: 99%

“…Several literature reports based on laboratory and clinical parameters have given controversial results concerning hemodynamic changes as well as endocrine responses during PN [1,2,3]. Treatments with clonidine, β-blockers, sodium nitroprusside and intravenous administration of fluid were tested to eliminate negative hemodynamic effects of PN in various animal studies [4,5,6]. …”

Section: Introductionmentioning

confidence: 99%

Effects of Animal Positioning on Catecholamine and Vasopressin Levels in Pigs Undergoing Laparoscopy

et al. 2011

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Background: The aim of this study was to determine the influence of different therapeutic interventions and positions on catecholamine and vasopressin levels in the pneumoperitoneum (PN) in a porcine model. Methods: In 43 pigs, a 14-mm-Hg PN was established and plasma concentrations of epinephrine, norepinephrine and vasopressin were measured in head-up, supine and head-down positions. Additionally, the effects of the following changes were studied: (1) increase in intrathoracic blood volume (ITBV) by means of hydroxyethyl starch infusion; (2) vasodilatation induced by sodium nitroprusside, or (3) selective sympathicolysis induced by esmolol. Again, catecholamines (ELISA) and vasopressin (RIA) were determined. Results: After PN, epinephrine levels did not significantly increase in the head-up position (p = 0.075) and remained also unchanged in the supine or head-down position. Plasma norepinephrine statistically significantly decreased in the head-up position (p = 0.046). Vasopressin concentrations remained unaltered. After increased ITBV, neither catecholamine nor vasopressin concentrations changed in any body position. Application of sodium nitroprusside or esmolol caused no changes. Conclusion: Changes in endogenous catecholamine levels safely prevent cardiocirculatory instability in small pigs. Volume substitution might reduce endocrine responses to PN in the head-up position.

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“…Increasing the intrathoracic blood volume improved hemodynamic function in all body positions with pneumoperitoneum. Fluid management is the most important element for minimizing pneumoperitoneum side efects [54].…”

Section: Complicationsmentioning

confidence: 99%

Anesthesia for Urological Surgery

Tekgül¹,

Horsanalı²,

OzanHorsanali³

2017

Current Topics in Anesthesiology

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Because of the variable techniques and patients' positions used in urological surgery, anesthesia for urologic surgery requires advanced knowledge and special transactions. In this mater, it is important to follow current approaches for anesthesiologists. Diferent surgical procedures and complications due to diferent positions or anesthesia were evaluated separately to be more concise. We have researched recent literature and created this chapter about new technologies in urological surgery and development in anesthesia for urological surgery.Keywords: urological anesthesia, anesthesia management, anesthesia complications, urological surgery complications IntroductionAnesthesia for urological surgery includes unique distinctive diferences, as in all other surgical departments. Therefore, anesthesia for urological surgery requires featured training and experience.To reduce the risk of complications in urological surgery, like all other kinds of surgery, regional anesthesia techniques came to prominence with the help of technological developments. For many urological ventures, only neuraxial blockade application could be enough. This also results in decreased complication risks. In surgeries that must be done with general anesthesia, epidural anesthesia can be used for the maintenance of anesthesia or in the postoperative period. In this way, the rate of intraoperative complications can be reduced and patients' comfort can be increased by providing postoperative pain control and also duration of hospital stay can be reduced [1].© 2017 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.During the urological surgery, diferent complications can develop depending on surgical techniques used. For example, most of urological ventures require lots of irrigation luids. In this venture, use of unheated irrigation luid can lead to complications such as hypothermia, delayed recovery from anesthesia and tremor [2].In addition to neuraxial blockade, the use of peripheral blockade has gained importance in urological surgery. For example, obturator blockade application for lateral wall localized bladder cancer could reduce intraoperative complications and increased cancer-free survival [3,4]. Anesthesia for kidney and upper urinary tract surgery Oncological surgery of kidney and upper urinary tract Radical and partial nephrectomyRenal cell carcinoma (RCC) is the ninth common cancer in the USA. According to the SEER database analysis, it is estimated that there will be 62,700 new cases and 14,240 people will die because of this disease. The incidence of kidney and renal pelvis cancer was 15.6 per 100,000 in the USA between 2009 and 2013 [5]. All around the world, radical or partial nephrectomy is accepted curative treatment for kidney tumors. Partial nephrectomy can be performed depending...

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Systematic evaluation of different approaches for minimizing hemodynamic changes during pneumoperitoneum

Cited by 19 publications

References 23 publications

Laparoscopic cholecystectomy with carbon dioxide pneumoperitoneum is safe even for high-risk patients

Laparoscopic cholecystectomy with carbon dioxide pneumoperitoneum is safe even for high-risk patients

Effects of Animal Positioning on Catecholamine and Vasopressin Levels in Pigs Undergoing Laparoscopy

Anesthesia for Urological Surgery

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