The effects of pneumoperitoneum pressure on blood gases, respiratory and venous systems during laparoscopic cholecystectomy: A prospective randomized trial

Aksakal, Nihat

doi:10.14744/less.2017.25744

Cited by 2 publications

(2 citation statements)

References 25 publications

(30 reference statements)

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“…It should be noted that even mild hyperventilation can adversely affect the Fontan circulation since hyperventilation itself can increase airway pressure. Aksakal et al reported that 8 mmHg insufflation increased PaCO 2 from a mean value of 33.4 mmHg to 35 mmHg and, more interestingly, to 38.1 mmHg after the end of insufflation in adult patients without heart disease undergoing laparoscopic cholecystectomy [ 5 ]. They suggested IAP might suppress CO 2 absorption from the capillaries.…”

Section: Discussionmentioning

confidence: 99%

Anesthetic Management of an Adult Patient Post a Fontan Procedure in Laparoscopic Surgery: A Case Report

Takemoto,

Asada,

Maki

et al. 2024

Cureus

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We report the successful anesthetic management of laparoscopic surgery in a 21-year-old female patient with Fontan circulation. A preoperative careful review of cardiac catheterization results helped assess the risk of the surgery and implement anesthetic management. Intraoperative management focused on minimizing the impact on pulmonary vascular resistance and venous return by optimizing ventilation and applying lower pneumoperitoneum pressure without tilting the position. Milrinone was administered to reduce pulmonary vascular resistance and provide inotropic support with minimally invasive monitoring. The patient remained stable throughout the procedure without complications. This case highlights the importance of thorough preoperative assessment, individualized intraoperative management, and collaboration with the surgical team when caring for adult Fontan patients undergoing laparoscopic surgery.

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Section: Discussionmentioning

confidence: 99%

Anesthetic Management of an Adult Patient Post a Fontan Procedure in Laparoscopic Surgery: A Case Report

Takemoto,

Asada,

Maki

et al. 2024

Cureus

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“…Despite a multitude of animal model studies on the physiological effects of pneumoperitoneum, the human body's specific response, particularly regarding changes in blood gases, respiratory, and venous systems, remains relatively unexplored. Moreover, the metabolic implications of pneumoperitoneum using CO 2 are not well documented, especially in COPD patients from Western countries and India [10]. Therefore, our research aims to investigate the changes in heart rate, mean arterial pressure, arterial and end-tidal CO 2 , and bicarbonate (HCO 3 ) during laparoscopic cholecystectomy in COPD patients, in order to contribute to the optimisation of anaesthetic management in this population.…”

Section: Introductionmentioning

confidence: 99%

Anaesthetic Management and Physiologic Effects of Pneumoperitoneum in Patients With Chronic Obstructive Pulmonary Disease Undergoing Laparoscopic Cholecystectomy

Gautam,

Harjai,

Sharma

et al. 2023

Cureus

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Objective: This study aimed to assess the physiological changes and clinical outcomes in patients with chronic obstructive pulmonary disease (COPD) undergoing laparoscopic cholecystectomy.Methods: This prospective cohort study included 50 patients of the American Society of Anesthesiology (ASA) physical status I and II with mild to moderate COPD (Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage I-II) scheduled for laparoscopic cholecystectomy. We monitored heart rate, mean arterial pressure, end-tidal carbon dioxide (EtCO 2 ), arterial carbon dioxide (PaCO 2 ), and bicarbonate (HCO 3 ) levels at baseline, 30 minutes after induction or 15 minutes post-insufflation, 15 minutes postdeflation, and 60 minutes post-operative. Perioperative complications and post-operative recovery characteristics were also observed. Descriptive statistics were used to summarise the demographic and clinical characteristics of the patients. The correlation between HCO 3 and EtCO 2 was plotted on a scatterplot, and Pearson's correlation 'r' was calculated. The changes in physiological parameters over time were analysed using a paired t-test. A p-value of less than 0.05 is considered statistically significant.Results: We observed a statistically significant but transient increase in heart rate, mean arterial pressure, and EtCO 2 at 30 minutes after induction or 15 minutes post-insufflation, which returned to baseline levels within 15 minutes of deflation. Similarly, arterial CO 2 and bicarbonate levels were also significantly increased at 15 minutes post-insufflation, yet remained within the normal physiological range. The study reported no serious perioperative complications, and all patients had an uneventful recovery.Conclusion: While patients with mild to moderate COPD can experience transient physiological changes during laparoscopic cholecystectomy, these changes are generally well-tolerated and not associated with adverse clinical outcomes. Therefore, laparoscopic cholecystectomy can be considered a safe procedure in these patients. Future research should focus on the implications and safety of this procedure in patients with severe COPD.

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The effects of pneumoperitoneum pressure on blood gases, respiratory and venous systems during laparoscopic cholecystectomy: A prospective randomized trial

Abstract: Introduction: Increased abdominal pressure during pneumoperitoneum may distress respiratory functions and venous systems. The aim of this study was to evaluate the effect of low and high pneumoperitoneum pressure during laparoscopic cholecystectomy.

Cited by 2 publications

References 25 publications

Anesthetic Management of an Adult Patient Post a Fontan Procedure in Laparoscopic Surgery: A Case Report

Anesthetic Management of an Adult Patient Post a Fontan Procedure in Laparoscopic Surgery: A Case Report

Anaesthetic Management and Physiologic Effects of Pneumoperitoneum in Patients With Chronic Obstructive Pulmonary Disease Undergoing Laparoscopic Cholecystectomy

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