Abstract
ABSTRACT
Our objective was to determine the hemodynamic effects of insufflation during gynecologic laparoscopic surgery using noninvasive hemodynamic monitoring. Between June 1994 and January 1995, patients undergoing scheduled laparoscopic surgery for benign gynecologic indications were recruited for perioperative hemodynamic monitoring by thoracic electrical bioimpedance (BoMed, Irvine, CA). After induction of general anesthesia, baseline hemodynamic parameters were obtained. A pneumoperitoneum (CO2) was created to 12 mm Hg, and hemodynamic parameters were again recorded. Hemodynamic parameters were likewise recorded at 10 min postinsufflation, immediately predeflation, immediately postdeflation, and 10 min postdeflation. Mean values (±SE) were plotted on a line bar graph and evaluated statistically by analysis of variance for repeated measures (ANOVA), α = 0.01. Insufflation significantly affected the systemic vascular resistance index and mean arterial pressure (p = 0.004 and p = 0.01). Specifically, insufflation increased the mean arterial pressure and systemic vascular resistance index, and desufflation had the opposite effect. A mirrored effect on cardiac index was likewise noted (p = 0.005). Although insufflation appeared to increase the heart rate, this effect was not significant. Likewise, the stroke index was not affected by insufflation. (J GYNECOL SURG 13:169, 1997)
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