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KMID : 0350519920450010283
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Journal of Catholic Medical College
1992 Volume.45 No. 1 p.283 ~ p.290
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Change of Hemodynamic Parameters and Plasma Catecholamine Level during Laparoscopic Cholecystectomy
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Abstract
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In the last decade, advances in laparoscopic equipment have allowed the development of laparoscopic surgical treatment for abdominal diseases.
Intra abdominal endoscopy can be extended for cholecystectomy.
Patients undergoing laparoscopy under general anesthesia exhibit various hemodynamics and blood gas changes.
To analyze the physiologic changes of these hemodynamic effects of laparoscopic cholecystectomy under general anesthesia, mean arterial blood pressure, heart rate, and tidal carbon dioxide and plasma catecholamine were measured.
Ten patients undergoing laparoscopic cholecystectomy were selected randomly.
Measurments of the above parameters were done about 10 minutes after tracheal intubation when the conditon of the patients was stabilized(control), shortly after completion of insufflation of peritoneal cavity with carbon dioxide, 30 minutes
after
insufflation of carbon dioxide and after deflation of carbon dioxide.
@ES The results were as follows;
@EN 1. The mean arterial pressures were 94.6*17.1 mmHg after tracheal intubation(control), 121.9*18.9 mmHg shortly after completion of insufflation of peritoneal cavity with CO2, 112.5*15.8 mmHg 30 minutes after CO2 insufflation and 113.0*12.1
mmHg
after deflation of CO2 from the peritoneal cavity, respectively.
2. The heart rates were 93.8*8.8/min after tracheal intubation, 96.4*13.5/min shortly after completion of insufflation of peritoneal cavity with CO2 97.9*8.6/min 30 minutes after CO2 insufflation and 93.2*7.7/min after deflation of CO2 from
peritoneal
cavity, respectively.
3. The and tidal carbon dioxide were 25.7*4.2 mmHg after tracheal intubation, 35.6*5.7 mmHg, shortly after completion of insufflation of peritoneal cavity with CO2 34.2*4.9 mmHg 30 minutes after CO2 insufflation and 35.9*7.1mmHg after deflation
of
CO2
from peritoneal cavity respectively.
4. The plasma epinephrine concentrations were 10.5*2.5pg/ml after tracheal intubation 26.5*5.1 pg/ml shortly after completion of insufflation with CO2, 32.5*8.9pg/ml 30 minutes after CO2 insufflation and 32.9*10.9pg/ml after deflation of CO2
from
the
peritoneal cavity, respectively.
5. The plasma norepinephrine concentrations were 49.9*11.4 pg/ml after tracheal intubation, 99.4*25.6 pg/ml shortly after completion of insufflation with CO2 94.8*19.1 pg/ml 30 minutes after CO2 insufflation and 106*23.1 pg/ml after deflation of
CO2
from the peritoneal cavity, respectively.
There were signficantly increased mean arterial pressure,and tidal carbon dioxide, plasma epinephrine, norepinephrine during CO2 insufflation into peritoneal cavity and maintained thereafter with deflation of CO2 from the peritonealcavity in
laparoscopic cholecystectomy.
In conclusion, these hemodynamic parameter changes seem to be correlated with the increased catecholamine release which was caused by sympathetic stimulation during the laparoscopic cholecystectomy.
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KEYWORD
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