The duration of hemodynamic depression during laparoscopic cholecystectomy

Zuckerman, Randall; Heneghan, Steven

doi:10.1007/s00464-001-9152-0

Cited by 30 publications

(12 citation statements)

References 15 publications

(19 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Recent studies recommend a moderate to low IAP (b12 mm Hg) as it limits the alteration in splanchnic perfusion, and consecutive organ dysfunctions will be minimal, transient, and will not influence the outcome [10]. Zuckerman and Heneghan [18] demonstrated that these changes are short lived and lose their statistical significance at 10 minutes from the time a patient undergoes pneumoperitoneum.…”

Section: Cardiovascular Effectsmentioning

confidence: 97%

Anesthesia for laparoscopy: a review

Gerges

Kanazi

Jabbour-Khoury

2006

Journal of Clinical Anesthesia

221

159

View full text Add to dashboard Cite

Section: Cardiovascular Effectsmentioning

confidence: 97%

Anesthesia for laparoscopy: a review

Gerges

Kanazi

Jabbour-Khoury

2006

Journal of Clinical Anesthesia

221

159

View full text Add to dashboard Cite

“…To adjust factors affecting intraoperative pressure, the BP at the beginning of CO 2 insufflation was compared with the mean BP within 30-60 min after insufflation. This is supported by the knowledge that hemodynamic changes begin to return to the pre-insufflation state via compensatory mechanisms approximately 15 min after gas insufflation (16). Nonetheless, the potential impact of each of these factors remains a limitation of this study.…”

Section: Discussionmentioning

confidence: 90%

Pneumoperitoneum in laparoscopy and preoperative antihypertensive agents: A retrospective study

Kim

2019

Exp Ther Med

View full text Add to dashboard Cite

The purpose of the current study was to investigate the effects of preoperative antihypertensive agents on blood pressure (BP) changes after intraperitoneal CO 2 insufflation during laparoscopic surgery. The medical records of patients (≥50 years old) undergoing laparoscopic colon surgery were retrospectively analyzed (n=342). The patients were divided into four groups: normotensive group (group N), monotherapy with angiotensin receptor blockers (ARBs) (group A), monotherapy with calcium channel blockers (CCBs) (group C), and combination therapy with ARBs and CCBs (group AC). The systolic BP changes were investigated, and their correlations with preoperative pulse pressure were analyzed. The degree of increase from baseline BP to that after CO 2 insufflation was significantly lower in groups A [difference vs. group N, 17.8; 95% confidence interval (CI), 7.8-27.8; P=0.001) and AC (18.2; 95% CI, 8.7-27.7; P<0.001] compared with groups N and C. The incidence of intraoperative hypotension was not significantly different among the groups. In groups A and AC, the preoperative pulse pressure showed a strong correlation (r=0.73 and 0.83, respectively) with the increase in BP after CO 2 insufflation. In conclusion, patients with hypertension who received ARBs before surgery showed a strong correlation between the preoperative pulse pressure and BP fluctuation immediately after CO 2 insufflation. Small BP fluctuations are suggested to indicate the positive role of ARBs. Large randomized controlled trials are required to validate these results and assess the effect of each antihypertensive agent. This trial was registered (Trial registration:

show abstract

“…6 Cardiac depression is usually transient with cardiac index returning to baseline levels within 10e15 minutes after abdominal insufflation. 8 At an IAP of 15 mmHg, there is an increase in systemic vascular resistance (SVR) and afterload due to compression of the abdominal aorta and increased catecholamine, vasopressin and renin angiotension activity. 2 Raised SVR increases mean arterial pressure.…”

Section: Cardiovascular Effects (mentioning

confidence: 99%

Anaesthesia and minimally invasive surgery

Irwin¹,

Wong²

2015

Anaesthesia & Intensive Care Medicine

View full text Add to dashboard Cite

Minimally invasive surgery is commonly performed because of various advantages such as reduced postoperative pain, faster recovery, and reduced postoperative pulmonary complications. However, anaesthesia for laparoscopy can be difficult and potentially hazardous in long, complex surgical procedures and in sick patients. Establishment of CO 2 pneumoperitoneum produces adverse pathophysiological changes due to increased IAP and hypercapnia, and these are further altered by postural changes. Laparoscopy is also associated with potential complications such as extraperitoneal gas insufflation and pneumothorax. It is important for the anaesthetist to understand the advantages and potential risks. General anaesthesia with endotracheal intubation is the most common anaesthetic technique, but supraglottic airway devices can sometimes be used. Neuroaxial anaesthesia has been used in some laparoscopic procedures as the sole anaesthetic technique. This article will focus on the pathophysiological changes caused by CO 2 pneumoperitoneum, the anaesthetic management for patients undergoing laparoscopy, and potential complications.

show abstract

The duration of hemodynamic depression during laparoscopic cholecystectomy

Abstract: Patients undergoing laparoscopic cholecystectomy experience significant hemodynamic depression with pneumoperitoneum. These changes are short-lived and lose their statistical significance at 10 min from the time a patient undergoes pneumoperitoneum.

Cited by 30 publications

References 15 publications

Anesthesia for laparoscopy: a review

Anesthesia for laparoscopy: a review

Pneumoperitoneum in laparoscopy and preoperative antihypertensive agents: A retrospective study

Anaesthesia and minimally invasive surgery

Contact Info

Product

Resources

About