Surgical laparoscopy & endoscopy
-
Surg Laparosc Endosc · Jun 1996
Cerebral oxygen metabolism measured by near-infrared laser spectroscopy during laparoscopic cholecystectomy with CO2 insufflation.
To clarify the influence of carbon dioxide (CO2) on cerebral oxygen metabolism and blood volume during laparoscopy with CO2 insufflation in 12 patients who underwent laparoscopic cholecystectomy, changes in the concentrations of cerebral oxyhemoglobin (HbO2), reduced hemoglobin (HbR), total hemoglobin (total Hb), and oxidized cytochrome aa3 (Cyt aa3) were measured using near-infrared laser spectroscopy. Anesthesia was maintained with nitrous oxide (66%)-oxygen-sevoflurane. Pneumoperitoneum was maintained at an endoabdominal pressure of 10 to 12 mm Hg using CO2. ⋯ Therefore, the concentration of total Hb increased significantly, from 0 to 8.8 +/- 3.3 mumol/L after CO2 insufflation. The concentration of Cyt aa3, however, did not change significantly during pneumoperitoneum. These results suggest that cellular respiration remained intact despite a concomitant increase in PETCO2 and cerebral blood volume during laparoscopy with CO2 insufflation.
-
Surg Laparosc Endosc · Jun 1996
Hemodynamic and respiratory changes during laparoscopic cholecystectomy with high and reduced intraabdominal pressure.
Laparoscopic cholecystectomy (lapchole) is a safe procedure. Most of the complications are operation related. The complications related to increased intraabdominal pressure (IAP) are well recognized, but not emphasized enough. ⋯ HR and SaO2 showed no significant changes. At T3 there was an increase in MAP by 24.94%, in AWP by 10%, and ETCO2 by 10.6% with no significant changes in HR and SaO2. Thus, operating under reduced IAP may be beneficial to the patients with decreased cardiopulmonary reserve, especially while undergoing long surgical procedures.