Haemodynamic effects of mechanical peritoneal retraction during laparoscopic cholecystectomy

Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie
P CoutureR Ratelle

Abstract

Abdominal wall retraction (AWR) was recently proposed as an alternative for CO2 pneumoperitoneum. In this study we evaluated the cardiorespiratory effects of AWR during laparoscopic cholecystectomy. Fifteen patients were studied during laparoscopic cholecystectomy using AWR. Monitoring included heart rate (HR), mean arterial pressure (MAP), pulse oxymetry (SpO2), end-tidal CO2 (PETCO2) minute ventilation, and peak inspiratory pressure (PIP). Using transoesophageal echocardiography, the transgastric short axis view was obtained to derive the end-diastolic area (EDA), the end-systolic area (ESA), and the ejection fraction (EF). These parameters were measured at predetermined periods: 1) five minutes after anaesthetic induction, 2) five minutes after AWR insertion, 3) 15 min after AWR insertion, and 4) after the end of surgery. No change in any measured parameter was observed over time in the AWR group except for an increase in MAP (P < 0.05) after AWR insertion. There were no changes in EDA, ESA and EF during the study, reflecting stable global cardiac function. In addition, no embolic episodes were observed during surgery. Our results demonstrate that the use of gasless abdominal distention for laparoscopic cholecystectomy resul...Continue Reading

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Citations

Jun 17, 1999·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·N H Badner
Apr 30, 1999·European Journal of Obstetrics, Gynecology, and Reproductive Biology·H KrissiZ Ben-Rafael
Aug 29, 2007·Surgery·Eric J HanlyMark A Talamini
Aug 12, 2000·Acta Anaesthesiologica Scandinavica·A M Koivusalo, L Lindgren

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