Study of the Effect of the Rate of Flow of Carbon Dioxide Gas for Creation of Pneumoperitoneum on Cardiovascular System during Laparoscopic Surgeries
Journal Title: International Journal of Innovative Research in Medical Science - Year 2016, Vol 1, Issue 3
Abstract
Laparoscopy has gained a worldwide acceptance due to its added advantages. Pneumoperitoneum required for this although aids in the surgical skill but invites a straight challenge to the attending anaesthesiologist for optimal control of haemodynamics .Reports of serious complication have been documented with abrupt and rough insufflation techniques of artificial creation of pneumoperitoneum ranging from mild bradycardia to frank cardiac arrest due to vagal mediated parasympathetic response due to rapid stretching of peritoneum. Gradual, gentle and slow rate of insufflation can prevent such complications. In this context, we have conducted a study on 40 patients of ASA I and ASA II, undergoing elective laparoscopic surgery requiring general anaesthesia with intubation. Patients were randomly allocated into study (A) and control (B) group. Group A (20 patients) comprises of the group where surgeon uses gradual and slow rate of insufflations of co2 whereas group B comprises of patients in which the surgeons uses abrupt and rapid insufflations of co2 at the rate of more than 4L/min and have found statistically significant hemodynamic changes in group B in comparison to Group A. Hence, we have concluded that insufflation with high flow rate while establishing artificial pneumoperitoneum increase IAP instantaneously and unexpected cardiovascular changes occurs such as hypotension, bradyarrhythmia whereas slow rate of insufflations prevents such complications. In patients with compromised cardio respiratory status, such vagal response with abrupt and rapid insufflations of co2 can prove to be detrimental .Therefore, not only maintaining IAP below 12-15 mmHg but also keeping slow insufflation rate (2-4lit/min) when establishing pneumoperitoneum is important and essential.
Authors and Affiliations
Dr. Sucheta Bhowate Meshram, Dr. Sandhya Gujar, Dr. Karuna Sidam, Dr. Tanumoy Maulick, Junior Resident
Keywords
Related Articles
- EP ID EP181147
- DOI -
- Views 113
- Downloads 0
A Rare Case of Adult Post Traumatic Diaphragmatic Hernia
Congenital diaphragmatic hernia (CDH) is a defect of the diaphragm associated with herniation of abdominal viscera into the chest cavity. We are going to report a case of post traumatic adult diaphragmatic hernia in a 45...
Measurement of Viscosity of Gummy Fibre from Syzygium Cumini Seeds and Its Co- Relationship to the Mobility and Dialysability of Sugar Molecules by In Vitro Dialysis Studies
Aim: 1. Measurement of Viscosity of Gummy Fibre from Syzygium Cumini Seeds and Its Co- relationship to the Mobility and Dialysability of sugar molecules by in Vitro Dialysis Studies. 2. The effect of water soluble gummy...
Significance of Serum Alkaline Phosphate and Lactate Dehydrogenase on Diagnosis and Prognosis of Gastrointestinal Cancer
The roles of enzymes especially alkaline phosphate (ALP), lactate dehydrogenase (LDH) in carcinogenesis in relation to disease activity have shown useful in estimating the extent and prognosis of malignant tumor in the d...
Bromatological Analysis from Medicinally Relevant Wild Edible Plant Parts
The wild edible plant parts such as tubers, rhizomes, corm, fruits, inflorescence, leaves, flowers, stems were consumed by rural peoples of Kolhapur district, Maharashtra, India. Ten wild edible plant species viz. Bauhin...
Sepsis Induced Acute Kidney Injury: Clinical Profile, Risk Factors and Outcomes in Tertiary Referral Centre
Sepsis increases the risk of development of acute kidney injury (AKI) and is associated with significant patient morbidity and mortality. Sepsis induced AKI is characterized by a distinct pathophysiology and therefore re...