Non-invasive pulse wave analysis for monitoring the cardiovascular effects of CO2pneumoperitoneum during laparoscopic cholecystectomy- a prospective case-series study

BMC Anesthesiology

Research Article

Szabolcs Lengyel¹  Dénes Páll¹  Lívia Orosz²  Csilla Molnár²  Réka Nemes²  Péter Sárkány²  Béla Fülesdi² 

[1] 1st Department of Medicine, University of Debrecen, Medical and Health Science Centre, Nagyerdei krt. 98, H-4032, Debrecen, Hungary;Department of Anesthesiology and Intensive Care, University of Debrecen, Medical and Health Science Centre, Nagyerdei krt. 98, H-4032, Debrecen, Hungary;

关键词: Laparoscopic cholecystectomy;    Hemodynamic changes;    Applanation tonometry;   

DOI  :  10.1186/1471-2253-14-98

 received in 2014-04-01, accepted in 2014-09-30,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundPeritoneal 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.Methods41 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).ResultsInduction 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.ConclusionsThe Sphigmocor pulse wave analysis system can be reliably used for detecting and monitoring cardiovascular changes occurring during laparoscopic cholecystectomy.

【 授权许可】

Unknown   
© Sárkány et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.