Haemodynamic effects of mechanical peritoneal retraction during laparoscopic cholecystectomy

被引:6
作者
Couture, P
Boudreault, D
Girard, F
Girard, D
Ratelle, R
机构
[1] UNIV MONTREAL, HOP NOTRE DAME, DEPT ANESTHESIOL, MONTREAL, PQ H2L 4M1, CANADA
[2] UNIV MONTREAL, HOP NOTRE DAME, DEPT SURG, MONTREAL, PQ H2L 4M1, CANADA
来源
CANADIAN JOURNAL OF ANAESTHESIA-JOURNAL CANADIEN D ANESTHESIE | 1997年 / 44卷 / 05期
关键词
D O I
10.1007/BF03011932
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Purpose: Abdominal wall retraction (AWR) was recently proposed as an alternative for CO2 pneumopentoneum. In this study we evaluated the cardiorespiratory effects of AWR during laparoscopic cholecystectomy. Methods: Fifteen patients were studied during laparoscopic cholecystectomy using AWR. Monitoring included heart rate (HR), mean arterial pressure (MAP), pulse oxymetry (SpO(2)), end-tidal CO2 (PETCO2), minute ventilation, and peak inspiratory pressure (PIP). Using transoesophageal echocardiography, the transgastric short axis view was obtained to derive the end-diastolic area (EDA), the end-systolic area (ESA), and the ejection fraction (EF). These parameters were measured at predetermined periods: I) live minutes after anaesthetic induction, 2) five minutes after AWR insertion, 3) 15 min after AWR insertion, and 4) after the end of surgery. Results: No change in any measured parameter was observed over time in the AWR group except for an increase in MAP (P<0.05) after AWR insertion. There were no changes in EDA, ESA and EF during the study, reflecting stable global cardiac function. In addition, no embolic episodes were observed during surgery. Conclusion: Our results demonstrate that the use of gasless abdominal distention for laparoscopic cholecystectomy results in a stable haemodynamic profile in healthy patients without cardiac disease, except for a brief increase in MAP after the AWR insertion. The advantages of AWR over conventional pneumoperitoneum should be confirmed in higher risk patients in a prospective, randomized study.
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收藏
页码:467 / 472
页数:6
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