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RSS FeedsNon-invasive pulse wave analysis for monitoring the cardiovascular effects of CO2 pneumoperitoneum during laparoscopic cholecystectomy- a prospective case-series study (BMC Anesthesiology)

 
 

31 october 2014 01:36:46

 
Non-invasive pulse wave analysis for monitoring the cardiovascular effects of CO2 pneumoperitoneum during laparoscopic cholecystectomy- a prospective case-series study (BMC Anesthesiology)
 


Background: Peritoneal 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. Methods: 41 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). Results: Induction 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. Conclusions: The Sphigmocor pulse wave analysis system can be reliably used for detecting and monitoring cardiovascular changes occurring during laparoscopic cholecystectomy.


 
145 viewsCategory: Medicine
 
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