Lower intra-abdominal pressure has no cardiopulmonary benefits during laparoscopic colorectal surgery: a double-blind, randomized controlled trial

Surgical Endoscopy
Youn Joung ChoJeong-Hwa Seo

Abstract

Higher intra-abdominal pressure may impair cardiopulmonary functions during laparoscopic surgery. While 12-15 mmHg is generally recommended as a standard pressure, the benefits of lower intra-abdominal pressure are unclear. We thus studied whether the low intra-abdominal pressure compared with the standard pressure improves cardiopulmonary dynamics during laparoscopic surgery. Patients were randomized according to the intra-abdominal pressure and neuromuscular blocking levels during laparoscopic colorectal surgery: low pressure (8 mmHg) with deep-block (post-tetanic count 1-2), standard pressure (12 mmHg) with deep-block, and standard pressure with moderate-block (train-of-four count 1-2) groups. During the laparoscopic procedure, we recorded cardiopulmonary variables including cardiac index, pulmonary compliance, and surgical conditions. We also assessed postoperative pain intensity and recovery time of bowel movement. The primary outcome was the cardiac index 30 min after onset of laparoscopy. Patients were included in the low pressure with deep-block (n = 44), standard pressure with deep-block (n = 44), and standard pressure with moderate-block (n = 43) groups. The mean (SD) of cardiac index 30 min after laparoscopy was 2.7 ...Continue Reading

References

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Citations

Sep 10, 2019·Anesthesia and Analgesia·Kim I AlbersThomas Fuchs-Buder
Dec 18, 2020·Anesthesia and Pain Medicine·Hyung Young Lee, Ki Tae Jung
Jun 27, 2021·Anaesthesia Critical Care & Pain Medicine·Philippe RichebéLouis-Philippe Fortier
Jun 29, 2021·Anaesthesia Critical Care & Pain Medicine·Glenn S Murphy
Jan 19, 2022·Surgical Endoscopy·Yuki UshimaruKiyokazu Nakajima

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