Non-invasive pulse wave analysis for monitoring the cardiovascular effects of CO2pneumoperitoneum during laparoscopic cholecystectomy- a prospective case-series studyReport as inadecuate




Non-invasive pulse wave analysis for monitoring the cardiovascular effects of CO2pneumoperitoneum during laparoscopic cholecystectomy- a prospective case-series study - Download this document for free, or read online. Document in PDF available to download.

BMC Anesthesiology

, 14:98

Perioperative medicine and outcome

Abstract

BackgroundPeritoneal 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.

Methods41 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.

ResultsInduction 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.

ConclusionsThe Sphigmocor pulse wave analysis system can be reliably used for detecting and monitoring cardiovascular changes occurring during laparoscopic cholecystectomy.

KeywordsLaparoscopic cholecystectomy Hemodynamic changes Applanation tonometry Electronic supplementary materialThe online version of this article doi:10.1186-1471-2253-14-98 contains supplementary material, which is available to authorized users.

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Author: Péter Sárkány - Szabolcs Lengyel - Réka Nemes - Lívia Orosz - Dénes Páll - Csilla Molnár - Béla Fülesdi

Source: https://link.springer.com/







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