Although physiological changes during laparoscopy and thoracoscopy generally are similar to those seen during standard open procedures, these minimally invasive techniques are accompanied by some unique changes. General, regional, and local anesthesia during laparoscopy and thoracoscopy, and potential complications, are discussed. The physiological responses that are discussed include hemodynamic effects, acid-base and pulmonary effects, and hormonal effects.
De GroodPmrm,Harbers Jbm, Egmond J., Crul JF: Anaesthesia for laparoscopy. A comparison of five techniques including propofol, etomidate, thiopentone, and isoflurane. Anaesthesia42:815-823, 1987
2.
Kenefick JP, Leader A., Maltby JR, Taylor PJ: Laparoscopy: Blood-gas values and minor sequelae associated with three techniques based on isoflurane. Br J Anaesth59:189-194, 1987
3.
Dodgson MS, HeierT., Steen PA: Atracurium compared with suxamethonium for outpatient laparoscopy . Br J Anaesth58:40S-43S, 1986 (suppl 1)
4.
Sengupta P., Skagel M., Plantevin OM: Postoperative morbidity associated with the use of atracurium and vecuronium in day-case laparoscopy. Eur J Anaesthesrol4:93-99, 1987
5.
Millard PR: Laparoscopy in a small community free-standing surgicenter. Am J Obstet Gynecol156:1480-1485, 1987
6.
MyattJK,Smith M., Plantevin OM, Crowther A.: Anaesthesia for day-stay laparoscopy. Br J Anaesth58:1200-1201, 1986
7.
Harvey DC, Charloton AJ, Findley IL: Comparison of morbidity between inpatients and outpatients following gynaecological laparoscopy. Ann R Coll Surg Engl67:103-104, 1985
8.
Gomar C., Fernandez C., Villalonga A., Nalda MA: Carbon dioxide embolism during laparoscopy and hysteroscopy. Ann Fr Anesth Reanim4:380-382, 1985
9.
Monk TG, Weldon BC: Anesthetic considerations for laparoscopic surgery, in Clayman RV, McDougall EM (eds): Laparoscopic Urology. St Louis, MO, Quality Medical, 1993, pp 19-27
10.
Alexander GD , Noe FE, Brown EM: Anesthesia for pelvic laparoscopy. Anesth Analg48:14-18, 1969
11.
Marco AP, Yeo CJ, Rock P.: Anesthesia for a patient undergoing laparoscopic cholecystectomy. Anesthesiology73:1268-1270, 1990
12.
Wittgen CM, Andrus CH, Fitzgerald SD, et al: Analysis of the hemodynamic and ventilatory effects of laparoscopic cholecystectomy. Arch Surg126:997-1001, 1991
13.
Taylor E., Feinstein R., Soper N., White PF: Effect of nitrous oxide on surgical conditions during laparoscopic cholecystectomy . Anesthesiology75:541-543, 1991
14.
Lonie DS, Harper Njn: Nitrous oxide anaesthesia and vomiting: The effect of nitrous oxide anaesthesia on the incidence of vomiting following gynaecological laparoscopy . Anesthesia41:703-707, 1986
15.
Bailie R., Craig G., Restall J.: Total intravenous anaesthesia for laparoscopy. Anaesthesia44:60-63, 1989
16.
Rising S., Dodgson MS, Steen PA: Isoflurane v fentanyl for outpatient laparoscopy. Acta Anaesthesiol Scand29:251-255, 1985
17.
Pandit SK, Kothary SP, Pandit UA, Mathai MK: Comparison of fentanyl and butorphanol for outpatient anaesthesia . Can J Anaesth34:130-134, 1987
18.
Smith RS, Organ CH: Gasless laparoscopywith conventional instruments: The next phase in minimally invasive surgery. San Francisco, CA, Norman, 1993
19.
Collins KM, Plantevin MB, Docherty PW: Comparison of atracurium and alcuronium in day-case gynaecological surgery . Anaesthesia39:1130-1134, 1984
Kong KL, Cooper GM: Recovery of neuromuscular function and postoperative morbidity following blockade by atracurium, alcuronium, and vecuronium. Anaesthesia43:450-453, 1988
22.
Raynes MA, Chisholm R., Woolner DF, Gibbs JM: A clinical comparison of atracurium and vecuronium in women undergoing laparoscopy . Anaesth Intensive Care15:310-316, 1987
23.
Sleigh JW, Matheson KH: The use of atracurium besylate for laparoscopy. Anaesthesia39:277-279, 1984
24.
Engbaek J., Ording H., Ostergaard D., Viby-Mogensen J.: Edrophonium and neostigmine for reversal of the neuromuscular blocking effect of vercuronium. Acta Anaesthesiol Scand29:544-546, 1985
25.
Hegarty JH, Brennan TG: Laparoscopy under local anesthesia: Our experience in 400 non-gynaecological patients. Ir J Med Sci152:276-278, 1983
26.
Poindexter AN, Abdul-Malak M., Fast JE: Laparoscopic tubal sterilization under local anesthesia. Obstet Gynecol75:5-8, 1990
27.
Phillips RS , Goldberg RI, Watson PW, et al: Mechanism of improved patient tolerance to nitrous oxide in diagnostic laparoscopy. Am J Gastroenterol82:143-144, 1987
28.
Lehtinen AM , Laatikainen T., Koskimies AI, Hovorka J.: Modifying effects of epidural analgesia or general anesthesia on the stress hormone response to laparoscopy for in vitro fertilization. J In Vitro Fertilization Embryo Transfer4:23-29, 1987
29.
Jones MJ, Mitchell RW, Hindocha N.: Effect of increased intra-abdominal pressure during laparoscopy on the lower esophageal sphincter. Anesth Analg68:63-65, 1989
30.
Wheeler AS, James FM: Local anesthesia for laparoscopy in a case of myotonia dystrophia . Anesthesiology50:169, 1979
31.
Peterson HB , Hulka JF, Speilman FJ, et al: Local versus general anesthesia for laparoscopic sterilization: A randomized study. Obstet Gynecol70:903-908, 1987
32.
Spielman FJ , HulkaJF,Ostheimer GW, Mueller RA: Pharmacokinetics and pharmacodynamics of local analgesia for laparoscopic tubal ligations. Am J Obstet Gynecol146:821-824, 1983
33.
Dunn GL, Morison DH, Fargas-Babjak AM, Goldsmith CH: A comparison of zomepirac and codeine as analgesic premedicants in short-stay surgery. Anesthesiology58:265-269, 1983
34.
Edwards ND, Barclay K., Catling SJ, et al: Day case laparoscopy: A survey of postoperative pain. Anaesthesia46:1077-1080,1991
35.
Skacel M., Sengupta P.: Morbidity after day case laparoscopy. A comparison of two techniques of tracheal anaesthesia. Anaesthesia41:537-541, 1986
36.
Smith BE, Suchak M., Siggins D., Challands J.: Rectus sheath block for diagnostic laparoscopy. Anaesthesia43:947-948, 1988
37.
Vegfors M., Cederholm I., Lennmarken C., Lofstrom JB: Should oxygen be administered after laparoscopy in healthy patients?Acta Anaesthesiol Scand32:350-352, 1988
38.
Pandit SK, Kothary SP, Pandit UA, et al: Dose-response study of droperidol and metoclopramide as antiemetics for outpatient anesthesia. Anesth Analg68:798-802, 1989
39.
Ho RT, Jawan B., Fung ST, et al: Electro-acupuncture and postoperative emesis. Anaesthesia45:327-329, 1989
40.
Parris Wcv , Lee EM: Anaesthesia for laparoscopic cholecystectomy . Anaesthesia46:997, 1991
41.
Ishizaki Y. , Bandai Y., Shimomura K., et al: Changes in splanchnic blood How and cardiovascular effects following peritoneal insufflation of carbon dioxide . Surg Endosc7:420-423, 1993
42.
Pricolo VE, Demaria EJ, Burchard KW: Venous return: Physiology, monitoring, and manipulation: Part I. Surgical Rounds, Sept, pp 703-707, 1993
43.
Ishizaki Y. , Bandai Y., Shimomura K., et al: Safe intraabdominal pressure of carbon dioxide pneumoperitoneum during laparoscopic surgery. Surgery114:549-554, 1993
44.
McKenzie R. , Wadhwa RK, Bedger RC: Noninvasive measurements of cardiac output during laparoscopy. J Reprod Med24:247-250, 1980
45.
Smith I., Benzie RJ, Gordon Nlm, et al: Cardiovascular effects of peritoneal insufflation of carbon dioxide for laparoscopy. BMJ14:410-411, 1971
46.
Marshall RL , Jebson Pjr, Davie T., Scott DB: Circulatory effects of carbon dioxide insufflation of the peritoneal cavity for laparoscopy. Br J Anaesth44:680-684, 1972
47.
Motew M., Ivankovich AD, Bieniarz J., et al: Cardiovascular effects and acid-base and blood gas changes during laparoscopy. Am J Obstet Gynecol115:1002-1012, 1973
48.
Liu SY, Leighton T., Davis I., et al: Prospective analysis of cardiopulmonary responses to laparoscopic cholecystectomy. J Laparoendosc Surg1:241-246, 1991
49.
Fitzgerald SD, Andrus CH, Baudendistel LJ, et al: Hypercarbia during carbon dioxide pneumoperitoneum. Am J Surg163:186-190, 1992
50.
Ho HS, Gunther RA, Wolfe BM: Intraperitoneal carbon dioxide insufflation and cardiopulmonary function . Arch Surg127:928-933, 1992
51.
Williams MD , Murr PC: Laparoscopic insufflation of the abdomen depresses cardiopulmonary function. Surg Endosc7:12-16,1993
52.
Leighton TA , Liu SY, Bongard FS: Comparative cardiopulmonary effects of carbon dioxide versus helium pneumoperitoneum. Surgery113:527-531, 1993
53.
Bongard FS, Pianim NA, Leighton TA, et al: Helium insufllation for laparoscopic operation. Surg Gynecol Obstet177:140-146, 1993
54.
Eisenhauer DM, Saunders CJ, Ho HS, Wolfe BM: Hemodynamic effects of argon pneumoperitoneum . Surg Endosc8:315-321, 1994
55.
Van de Bos GC, Drake AJ, Noble MI: The effect of carbon dioxide upon myocardial contractile performance, blood How and oxygen consumption . J Physiol287:149-161, 1979
56.
Alexander GD , Brown EM: Physiologic alterations during pelvic laparoscopy . Am J Obstet Gynecol105:1078-1081, 1969
57.
Mango R., Medegard A., Bengtsson R., Tronstad SE: Acid-base balance during laparoscopy. Acta Obstet Gynecol Scand58:81-85, 1979
58.
El-Minawi MF , Wahbi O., El-Bagouri IS, et al: Physiologic changes during CO2 and N2O pneumoperitoneum in diagnostic laparoscopy-A comparative study. J Reprod Med26:338-346,1981
59.
Leighton T. , Pianim N., Liu SY, et al: Effectors of hypercarbia during experimental pneumoperitoneum. Am Surg52:717-721, 1992
60.
Wittgen CM, Naunheim KS, Andrus CH, Kaminski DL: Preoperative pulmonary function evaluation for laparoscopic cholecystectomy . Arch Surg128:880-886, 1993
61.
Brampton WJ , Watson RJ: Arterial to end-tidal carbon dioxide tension differences during laparoscopy. Magnitude and effect of anaesthetic technique . Anaesthesia45:210-214, 1990
62.
Holzman M., Sharp K., Richards W.: Hypercabia during carbon dioxide gas insufflation for therapeutic laparoscopy: A note of caution. Surg Laparosc Endosc2:11-14, 1992
63.
Safran D., Sgambati S., Orlando R.: Laparoscopy in high-risk cardiac patients. Surg Gynecol Obstet176:548-554, 1993
64.
Massie MT, Massie LB, Marrangoni AG, et al: Advantages of laparoscopic cholecystectomy in the elderly and in patients with high ASA classifications. J Laparoendosc Surg3:467-476,1993
65.
Wittgen CM, Andrus JP, Andrus CH, Kaminski DL: Cholecystectomy: Which procedure is best for the high-risk patient?Surg Endosc7:395-399, 1993
66.
Barnett RB, Clement GS, Drizin GS, et al: Pulmonary changes after laparoscopic cholecystectomy. Surg Laparosc Endosc2:125-127, 1992
67.
Johnson D., Litwin D., Osachoff J., et al: Postoperative respiratory function after laparoscopic cholecystectomy . Surg Laparosc Endosc2:221-226, 1992
68.
Poulin EC, Mamazza J., Breton G., et al: Evaluation of pulmonary function in laparoscopic cholecystectomy . Surg Laparosc Endosc2:292-296, 1992
69.
Melville RJ , Frizis HI, Forsling ML, LeQuesne LP: The stimulus for vasopressin release during laparoscopy. Surg Gynecol Obstet161:253-256, 1985
70.
Solis Herruzo JA, Castellano G., Larrodera L., et al: Plasma arginine vasopressin concentration during laparoscopy. Hepatogastroenterology36:499-503, 1989
Lefebvre G. , Thirion AV, Vauthier-Brouzes D., et al: Laparoscopic surgery versus laparotomy. Comparative analysis of stress markers. J Gynecol Obstet Biol Reprod21:507-511, 1992
73.
Senagore A. , Kilbride M., Luchtefeld M., et al: Cortisol and IL-6 response attenuated following laparoscopic colectomy. Surg Endosc7:121, 1993 (abstr)
74.
Griffith J. , Everitt N., Curley P., McMahon M.: Laparoscopic versus "open" cholecystectomy-Reduced influence upon immune function and the acute phase response. Surg Endosc7:123, 1993 (abstr)
75.
Kent RB: Subcutaneous emphysema and hypercarbia following laparoscopic cholecystectomy . Arch Surg126:1154-1156, 1991
76.
Doctor NH, Hussain Z.: Bilateral pneumothorax associated with laparoscopy-A case report of a rare hazard and review of literature. Anaesthesia28:75-81, 1973
77.
Batra MS, Driscoll JJ, Coburn WA, Marks WM: Evanescent nitrous oxide pneumothorax after laparoscopy. Anesth Analg62:1121-1123, 1983
Page RD, Jeffrey RR, Donnelly RJ: Thoracoscopy: A review of 121 consecutive surgical procedures. Ann Thorac Surg48:66-68, 1989
96.
Wakabayashi A.: Expanded applications of diagnostic and therapeutic thoracoscopy. J Thorac Cardiovasc Surg102:721-723, 1991
97.
Hucker J., Bhatnagar NK, Al-Jilaihawi AN, Forrester-Wood CP: Thoracoscopy in the diagnosis and management of recurrent pleural effusions . Ann Thorac Surg52:1145-1147, 1991
98.
Rogers DA, Philippe PG, Lobe TE, et al: Thoracoscopy in children: An initial experience with an evolving technique. J Laparoendoscop Surg2:7-14, 1992
99.
Ryckman FC, Rodgers BM: Thoracoscopy for intrathoracic neoplasia in children. J Pediatr Surg17:521-524, 1982
100.
Menzies R., Charbonneau M.: Thoracoscopy for the diagnosis of pleural disease. Ann Intern Med114:271-276, 1991
101.
Rodgers BM, Moazam F., Talbert JL: Thoracoscopy: Early diagnosis of interstitial pneumonitis in the immunologically suppressed child. Chest75:126-130, 1979
102.
Rodgers BM , Moazam F., Talbert JL: Thoracoscopy in children . Ann Surg189:176-180, 1979
103.
Oldenburg FA, Newhouse MT: Thoracoscopy: A safe, accurate diagnostic procedure using the rigid thoracoscope and local anesthesia. Chest75:45-50, 1979
104.
Rusch VW, Mountain C.: Thoracoscopy under regional anesthesia for the diagnosis and management of pleural disease. Am J Surg154:274-278, 1987
105.
Rodgers BM , Ryckman FC, Moazam F., Talbert JL: Thoracoscopy for intrathoracic tumors. Ann Thorac Surg31:414-420, 1981
106.
Jones JW, Kitahama A., Webb WR, McSwain N.: Emergency thoracoscopy: A logical approach to chest trauma management . J Trauma21:280-284, 1981
