The online version of this article (doi:10.1186/1471-2253-14-98) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
PS: Intraoperative measurements, drafting of the manuscript. SL: Intraoperative measurements. RN: Intraoperative measurements, statistical analysis. LO: Intraoperative measurements, drafting of the manuscript. DP: Study protocol consultation. CM: Study protocol, drafting of the manuscript. BF: Study protocol, drafting of the manuscript. All authors read and approved the final manuscript.
Peritoneal insufflation results in hemodynamic changes during laparoscopic cholecystectomy. The aim of the present work is to test whether non-invasive applanation tonometry is suitable for reflecting these hemodynamic alterations.
41 patients undergoing laparoscopic cholecystectomies were monitored using the SphygmoCor pulse wave analysing system. Peripheral blood pressures (PBP), central aortic blood pressures (CBP), augmentation index (ALX@HR75) and subendocardial viability ratio (SVR) were measured at rest (Phase 1), after anesthetic induction (Phase 2), after peritoneal inflation (Phase 3) and after peritoneal deflation (Phase 4).
Induction of anesthesia resulted in a statistically significant reduction in both the peripheral blood pressure and central aortic pressures, accompanied by a decrease in augmentation pressure and augmentation index. Peripheral blood pressures did not change along with the peritoneal cavity insufflation, except for a moderate increase in systolic blood pressure. In contrast to this, an increase could be observed in central aortic pressure (106.77 ± 18.78 vs. 118.05 ± 19.85 mmHg, P < 0.01) which was accompanied by increased augementation pressure (18.97 ± 10.80 vs. 31.55 ± 12.01; P < 0.001) and augmentation index (7.31 ± 5.59 vs. 12.61 ± 7.56, P < 0.001), indicating a rise in peripheral arterial stiffness.
The Sphigmocor pulse wave analysis system can be reliably used for detecting and monitoring cardiovascular changes occurring during laparoscopic cholecystectomy.
Bliacheriene F, Machado SB, Fonseca EB, Otsuke D, Auler JO, Michard F: Pulse pressure variation as a tool to detect hypovolaemia during pneumoperitoneum. Acta Anaesthesiol Scand. 2007, 51: 1268-1272. PubMed
Turkistani AA: Cardiodynamic monitoring during laparoscopic cholecystectomy. Middle East J Anesthesiol. 2005, 18: 435-439. PubMed
Galizia G, Prizio G, Lieto E, Castellano P, Pelosio L, Imperatore V, Ferrara A, Pignatelli C: Hemodynamic and pulmonary changes during open, carbon dioxide pneumoperitoneum and abdominal wall-lifting cholecystectomy. A prospective, randomized study. Surg Endosc. 2001, 15: 477-483. 10.1007/s004640000343. CrossRefPubMed
Feig BW, Berger DH, Dupuis JF: Hemodynamic effects of CO2 abdominal insufflation (CAI) during laparoscopy in high-risk patients. Anesth Analg. 1994, 78: S109-
Cinnella G, Grasso S, Spadaro S, Rauseo M, Mirabella R, Salatto P, De Capraris A, Nappi L, Greco P, Dambrosio M: Effects of Recruitment Maneuver and Positive End-expiratory Pressure on Respiratory Mechanics and Transpulmonary Pressure during Laparoscopic Surgery. Anesthesiology. 2013, 118: 114-122. 10.1097/ALN.0b013e3182746a10. CrossRefPubMed
Safran D, Sgambati S, Orlando R: Laparoscopy in high-risk cardiac patients. Surg Gynecol Obstet. 1993, 176: 548-554. PubMed
- Non-invasive pulse wave analysis for monitoring the cardiovascular effects of CO2pneumoperitoneum during laparoscopic cholecystectomy- a prospective case-series study
- BioMed Central
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