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 93
- Downloads 0
The Prognostic Value of β-catenin Expression in Endometrial Cancer
Objective: To investigate the prognostic value of β-catenin expression in endometrial cancer. Methods: Immunohistochemistry was used to evaluate samples from 27 early stage and 39 advanced stage endometrial cancers. Smea...
Gross and Morphometric Evaluation of Deltoideus Muscle of Cattle and One-Humped Camel
The study was conducted using 25 forelimbs each obtained from male camels (Camelus dromedarius) and cattle (Zebu type) purchased from Sokoto Municipal Modern abattoir. The animals were within the ages of 6 months, 1year,...
Frequency of Junk Food and Depression in Children
Introduction: Consumption of junk food has a profound detrimental effect on psychological health. Participants who ate commercial foods especially doughnuts were at risk of mental health problems. Materials and Methods:...
Perianal Fixed Drug Eruption Mimicking Herpes Infection Due to Ibuprofen- A Rare Case Report
Abstract: The fixed drug eruption (FDE) is a special form of drug induced dermatological disorder characterized by development of erythematous or pigmented patches. We are presenting a very rare case of FDE mimicking per...
ROLE OF MOLECULAR MODELLING IN DRUG DESIGN
Molecular modeling includes all theoretical methods and computational techniques used to model or mimic the behavior of molecules. The techniques are used in the fields of computational chemistry, drug design, computatio...