Article (Scientific journals)
Hemodynamic changes during laparoscopic cholecystectomy.
Joris, Jean; Noirot, Didier P; Legrand, Marc et al.
1993In Anesthesia and Analgesia, 76 (5), p. 1067-71
Peer Reviewed verified by ORBi
 

Files


Full Text
209.pdf
Publisher postprint (513.93 kB)
Request a copy

All documents in ORBi are protected by a user license.

Send to



Details



Keywords :
Adult; Aged; Anesthesia, Inhalation; Blood Pressure/physiology; Carbon Dioxide/administration & dosage; Cardiac Output/physiology; Cholecystectomy, Laparoscopic; Female; Hemodynamics/physiology; Humans; Insufflation; Isoflurane; Male; Middle Aged; Peritoneum; Respiration/physiology
Abstract :
[en] Hemodynamics during laparoscopic cholecystectomy under general anesthesia (isoflurane in N2O/O2 (50%)) were investigated in 15 nonobese ASA Class I patients by using invasive hemodynamic monitoring including a flow-directed pulmonary artery catheter. During surgery, intraabdominal pressure was maintained automatically at 14 mm Hg by a CO2 insufflator, and minute ventilation was controlled and adjusted to avoid hypercapnia. Hemodynamics were measured before anesthesia, after the induction of anesthesia, after tilting into 10 degrees head-up position, 5 min, 15 min, and 30 min after peritoneal insufflation, and 30 min after exsufflation. Induction of anesthesia decreased significantly mean arterial pressure and cardiac index (CI). Tilting the patient to the head-up position reduced cardiac preload and caused further reduction of CI. Peritoneal insufflation resulted in a significant increase (+/- 35%) of mean arterial pressure, a significant reduction (+/- 20%) of CI, and a significant increase of systemic (+/- 65%) and pulmonary (+/- 90%) vascular resistances. The combined effect of anesthesia, head-up tilt, and peritoneal insufflation produced a 50% decrease in CI. Administration of increasing concentrations of isoflurane, via its vasodilatory activity, may have partially blunted these hemodynamic changes. These results demonstrate that laparoscopy for cholecystectomy in head-up position results in significant hemodynamic changes in healthy patients, particularly at the induction of pneumoperitoneum.
Disciplines :
Surgery
Anesthesia & intensive care
Author, co-author :
Joris, Jean ;  Centre Hospitalier Universitaire de Liège - CHU > Anesthésie et réanimation
Noirot, Didier P
Legrand, Marc ;  Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
Jacquet, Nicolas J
Lamy, Maurice ;  Université de Liège - ULiège > Département des sciences cliniques > Département des sciences cliniques
Language :
English
Title :
Hemodynamic changes during laparoscopic cholecystectomy.
Publication date :
1993
Journal title :
Anesthesia and Analgesia
ISSN :
0003-2999
eISSN :
1526-7598
Publisher :
Lippincott Williams & Wilkins, Baltimore, United States - Maryland
Volume :
76
Issue :
5
Pages :
1067-71
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 27 October 2009

Statistics


Number of views
154 (16 by ULiège)
Number of downloads
7 (5 by ULiège)

Scopus citations®
 
470
Scopus citations®
without self-citations
464
OpenCitations
 
370

Bibliography


Similar publications



Contact ORBi