| 1. |
- Lindberg, F, et al.
(författare)
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Hemodynamic changes in the inferior caval vein during pneumoperitoneum. An experimental study in pigs.
- 1997
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Ingår i: Surgical Endoscopy. - : Springer Science and Business Media LLC. - 0930-2794 .- 1432-2218. ; 11:5, s. 431-7
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Laparoscopic procedures of increasing difficulty and duration are becoming more and more common. This may cause significant challenges to the circulatory system and possibly influence thrombogenicity.METHODS: Experimental study of carbon dioxide pneumoperitoneum in pigs.RESULTS: Inferior caval vein blood flow remained unchanged, whereas inferior caval vein pressure increased during pneumoperitoneum. Inferior caval vein, pulmonary, and systemic vascular resistance increased during pneumoperitoneum and remained increased after exsufflation.CONCLUSIONS: Pneumoperitoneum leads to an increased inferior caval vein pressure, which could cause a dilation of peripheral veins. The similar patterns of vascular resistance in the inferior caval vein, pulmonary artery, and systemic arteries (a gradual increase remaining elevated after exsufflation) suggest a common humoral factor or increased sympathetic nerve activity.
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| 2. |
- Odeberg, S., et al.
(författare)
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Lack of neurohumoral response to pneumoperitoneum for laparoscopic cholecystectomy
- 1998
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Ingår i: Surgical Endoscopy. - : Springer-Verlag New York. - 0930-2794 .- 1432-2218. ; 12:10, s. 1217-1223
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Tidskriftsartikel (refereegranskat)abstract
- Background: Pneumoperitoneum (PP) for laparoscopic surgery induces prompt changes in circulatory parameters. The rapid onset of these changes suggests a reflex origin, and the present study was undertaken to evaluate whether release of vasopressor substances could be responsible for these alterations. The influence of two different anesthesia techniques was also evaluated. Methods: American Society of Anesthesiologists (ASA) class I patients, scheduled for laparoscopic cholecystectomy, were investigated. The first group (n = 10) was anesthetized intravenously. The second group (n = 6) had inhalation anesthesia. Plasma vasopressin, catecholamines, and plasma renin activity were investigated as neurohumoral vasopressor markers of circulatory stress. The general stress response to surgery was assessed by analysis of plasma cortisol. Results: Induction of pneumoperitoneum caused no apparent activation of vasopressor substances, although several hemodynamic parameters responded promptly. Conclusion: The hemodynamic alterations, seen at the establishment of PP during stable anesthesia, cannot be explained by elevation of vasopressor substances in circulating blood.
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