The relationship among carbon dioxide pneumoperitoneum, vasopressin release, and hemodynamic changes

被引:51
作者
Mann, C
Boccara, G
Pouzeratte, Y
Eliet, J
Serradeil-Le Gal, C
Vergnes, C
Bichet, DG
Guillon, G
Fabre, JM
Colson, P
机构
[1] Fac Med Montpellier, Lab Anesthesiol, Montpellier, France
[2] Fac Med Montpellier, Chirurg Expt Lab, Montpellier, France
[3] Ctr Pharmacol Endocrinol, Montpellier, France
[4] Sanofi Rech, Biochim Exploratoire, F-31036 Toulouse, France
[5] CHU Montpellier, Dept Med Informat, Montpellier, France
[6] Hop Sacre Coeur, Ctr Rech, Montreal, PQ H4J 1C5, Canada
关键词
D O I
10.1097/00000539-199908000-00003
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
We assessed the role of vasopressin (VP) for the hemodynamic response to pneumoperitoneum in pigs. Four groups of anesthetized pigs were investigated. Nine pigs were intraabdominally insufflated with CO2 and eight were intraabdominally insufflated with argon; eight pigs received an IV injection of 1 mg/kg SR 49059, a VP antagonist, before CO2 insufflation; and six pigs received SR 49059 alone. Hemodynamics, plasma concentrations of VP and vasoactive hormones, and Pace, were measured. Data were analyzed by using analysis of variance, Student's t-test, and Mann-Whitney U-test. Five minutes after insufflation, changes in systemic vascular resistance (SVR) were significantly correlated with changes in VP (r = 0.72; P = 0.005) but not with changes in epinephrine, norepinephrine, renin activity, or PaCO2. SVR increased during CO2 insufflation but not during argon insufflation or CO2 insufflation with a preceding infusion of SR 49059. The SR 49059 injection itself resulted in increases in heart rate and cardiac output and decreases in blood pressure and SVR. We conclude that, during CO2 pneumoperitoneum in pigs, absorbed CO2 initiates a pathophysiological process that stimulates VP release. Hence, VP most likely plays a key role in the hemodynamic response to a CO2-induced pneumoperitoneum. Implications: Intraabdominal insufflation of CO2 is associated with hemodynamic and hormonal changes. Investigating CO2 and argon-insufflated pigs and using a vasopressin antagonist, we found that CO2 insufflation released vasopressin, which, in turn, induced hemodynamic perturbances.
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页码:278 / 283
页数:6
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