|
KMID : 0616619990050020347
|
|
Journal of Soonchunhyang Medical College
1999 Volume.5 No. 2 p.347 ~ p.355
|
|
|
Hemodynamic and Arterial Blood Gas Changes during Laparoscopic Cholecystectomy
|
|
|
|
|
Abstract
|
|
|
Laparoscopic cholecystectomy is a commonly performed procedure for the treatment of symptomatic gallstone disease and has advantage of lesser postoperative pain, more rapid recovery and lesser scar compared with conventional open cholecystectomy. Laparoscopic procedure uses carbon dioxide to make artificial pneumoperitoneum.
Insufflation of carbon dioxide into the peritoneal cavity may result in serious hypercapnea caused, in part, by the absorption of gas across the peritoneal surface. pneumoperitoneum induced by carbon dioxide may result in respiratory and hemodynamic changes.
Therefore we studied the arterial blood gas and hemodynamic changes during laparoscopic cholecystectomy under the general anesthesia in forty patients.
We checked blood pressure, pulse rate and sampled arterial blood for blood gas analysis serially. For the statistical analysis of the variables in the study, the paired t-test was used to assess the significance of differences between two groups, with p values less than 0.05 as statistically significant.
The results are as follows
1) diastolic blood pressure (p<0.05) increased during operation increased and normalized after deflation of CO₂.
2) PaCO₂(p<0.05) value during the operation increased with statistical meaning.
3) There is no significant changes in systolic blood pressure and pulse rate, the pH, HCO₃-value, and electrolyte during the operation.
In summery, pneumoperitoneum induced by CO₂insufflation below 15mmHg of intrabdominal pressure for laparoscopic surgery had not any harmful hemodynamic or respiratory effect in the healthy person, except changes of diastolic blood pressure, PCO₂with statistical significance.
We need to further study the harmful effects of CO₂pneumoperitoneum, especially in the patients with poor cardiopulmonary function.
|
|
|
KEYWORD
|
|
|
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|
|