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Effect of Carbon Dioxide for Laparoscopic Cholecystectomy on Arterial Pressure in Obese and Nonobese Patients
Nada Vranko
Ivan Šklebar
Abstract
The effect of carbon dioxide induced pneumoperitoneum and anti-Trendelenburg.s position on arterial pressure was retrospectively analyzed in 34 patients with cholelithiasis and overweight and 34 patients with cholelithiasis and normal body weight. According to general condition, all patients belonged to ASA II and ASA III groups. Upon induction in general endotracheal balanced anesthesia, patients received intermittent positive pressure ventilation. At the time of arterial pressure measurement, the following parameters were determined: respiratory volume 12 mL kg-1 body weight, respiration rate 12 breaths per minute, and inhalation to exhalation time ratio I:E=1:2. Arterial pressure was measured by automated noninvasive method in horizontal position before induction in general anesthesia (T1), upon induction in general anesthesia (T2), upon carbon dioxide inflation into abdominal cavity and antiTrendelenburg.s position at 25° (T3), upon carbon dioxide deflation from abdominal cavity (T4), and upon completion of the operation and patient extubation (T5). Arterial pressure showed a statistically significant increase after carbon dioxide inflation and a statistically significant decrease upon carbon dioxide deflation (p<0.002 both) in both study groups. In overweight patients, both systolic and diastolic pressure increased with carbon dioxide induced pneumoperitoneum to a mean value of 167±18 mm Hg and 102±10 mm Hg, respectively, as measured at T3. In the group of patients with normal body weight, the respective pressure values were 156±19 mm Hg and 98±9 mm Hg at the same time point.
Keywords
Laparoscopic cholecystectomy; Pneumoperitoneum; Carbon dioxide; Intra-abdominal pressure; Overweight; General endotracheal balance anesthesia
Hrčak ID:
14094
URI
Publication date:
1.5.2006.
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