Further Studies on the Acute Effects of Intra-Abdominal Pressure

Booker, Walter M.; French, David M.; Molano, Pedro A.

doi:10.1152/ajplegacy.1947.149.2.292

Cited by 14 publications

(7 citation statements)

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“…Other investigators have studied the effects of the Trendelenburg position in patients undergoing laparoscopy [3,11,28]. Hemodynamic changes may be influenced by the degree of head-down tilt, intravascular volume status, age of the patient, associated cardiac disease, anesthetic drugs, and ventilation techniques.…”

Section: Effects Of the Steep Trendelenburg Positionmentioning

confidence: 99%

The effects of elevated intraabdominal pressure, hypercarbia, and positioning on the hemodynamic responses to laparoscopic colectomy in pigs

Horvath

Whelan

et al. 1998

Surgical Endoscopy

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The effects of laparoscopic surgery and open surgery on hemodynamic responses are minimal, and no one method is superior to another when performed in pigs that are healthy, hydrated, and hyperventilated to keep ETCO2 < 40. However, since elderly and sick patients have a lower threshold for physiologic decompensation, we can infer that the small hemodynamic changes noted in this study might become significant factors when surgery is performed on compromised patients. The finding that an abdominal wall lifting device causes the fewest metabolic and hemodynamic effects makes its use an important consideration when performing laparoscopic surgery in patients with cardiopulmonary compromise, hemodynamic instability, or any preexisting renal insufficiency.

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Section: Effects Of the Steep Trendelenburg Positionmentioning

confidence: 99%

The effects of elevated intraabdominal pressure, hypercarbia, and positioning on the hemodynamic responses to laparoscopic colectomy in pigs

Horvath

Whelan

et al. 1998

Surgical Endoscopy

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“…During insufflation using the standard autoregulator laparoscopic insufflator, we selected a set point of 12 mmHg, based on common clinical safety experience and published animal data on safe intraabdominal pressure for surgical pneumoperitoneum [1,3,8,14]. Intraabdominal pressure measurements showed good correlation without statistically significant differences between the three measurement routes (a Veress needle, the biopsy channel of the endoscope, or a standard laparoscopic trocar) according to one-way analysis of variance (ANOVA) using a p value of 0.97.…”

Section: Resultsmentioning

confidence: 99%

“…We selected 12 mmHg as our set point on the basis of conventional laparoscopic experience that has established 15 mmHg as the upper limit for safe intraabdominal pressure, with intraabdominal hypertension and associated untoward effects expected above 20 to 25 mmHg [1,3,8,14]. In our experiments, the intraabdominal pressures demonstrated minimal variation (range, 8-15 mmHg; mean, 11.1 ± 2.2 mmHg).…”

Section: Discussionmentioning

confidence: 99%

Comparison of intraabdominal pressures using the gastroscope and laparoscope for transgastric surgery

et al. 2007

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“…studied the acute effects of abdominal pressure changes. [11] Hemodynamic changes are mainly observed in a patient who is undergoing laparoscopic surgery during intubation, pneumoperitoneum, reverse trendelenburg position, and while extubation. [12] All these changes are well tolerated in patients with normal cardiovascular function.…”

Section: Discussionmentioning

confidence: 99%

The effectiveness of intravenous dexmedetomidine on perioperative hemodynamics, analgesic requirement, and side effects profile in patients undergoing laparoscopic surgery under general anesthesia

et al. 2017

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Background:There is an upward surge in the use of laparoscopic surgeries due to various advantages when compared to open surgeries. Major advantages are, due to small incisions which are cosmetically acceptable and most of them are now daycare procedures. Problem of economic burden and hospital bed occupancy has been overcome with laparoscopic surgeries. All these advantages are not free from disadvantages, as hemodynamic changes such as hypertension; tachycardia and other surgical-related complications are commonly observed intraoperatively. Dexmedetomidine is one of the α2 agonist drugs which acts at both supraspinal and spinal level and modulate the transmission of nociceptive signals in the central nervous system. The basic effect of dexmedetomidine on the cardiovascular system is to decrease the heart rate and systemic vascular resistance with additional feature of opioid sparing effect. This drug has become an ideal adjuvant during general anesthesia, especially when stress is expected. Hence, the drug was studied in laparoscopic surgeries.Aims and Objectives:(a) To study the effect of dexmedetomidine on hemodynamic parameters during perioperative period in patients undergoing laparoscopic surgery. (b) To study the postoperative sedation score and analgesic requirement. (c) To study the side effect profile of dexmedetomidine.Settings and Design:Randomized double blind controlled trial.Subjects and Methods:After obtaining the Institutional Ethical Clearance, the study was conducted. Forty patients of American Society of Anesthesiologists Class I and II were enrolled in this randomized study. The patients were randomly divided into two groups; group normal saline (NS) and group dexmedetomidine. Patient received either NS or dexmedetomidine in group NS and group dexmedetomidine, respectively, depending upon the allocation. The infusion rate was adjusted according to; loading dose (1 μg/kg) over 10 min and maintenance dose (0.5 μg/kg/h) and perioperative hemodynamics was recorded. Routine general anesthesia was administered in all the patients with conventional technique without deviating from institutional protocols. Postoperatively, Rasmsay sedation score, time taken for request of first analgesic dose, and side effects if any were recorded.Statistical Analysis Used:The categorical factors are represented by the number and frequency (%) of cases. The continuous variables are represented by measures of central frequency and standard deviation. The statistical analysis was done by using unpaired t-test and Chi-square. P < 0.05 was considered statistically significant.Results:Significant hemodynamic changes are observed in NS group during laryngoscopy, intubation, during pneumoperitoneum formation, and during extubation. Hemodynamic stress response in dexmedetomidine group was significantly attenuated. Analgesic requirement during postoperative 24 h were much less in dexmedetomidine group when compared to NS group. No significant side effects were noted except for bradycardia; which was observed in two cases of ...

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Further Studies on the Acute Effects of Intra-Abdominal Pressure

Cited by 14 publications

References 0 publications

The effects of elevated intraabdominal pressure, hypercarbia, and positioning on the hemodynamic responses to laparoscopic colectomy in pigs

The effects of elevated intraabdominal pressure, hypercarbia, and positioning on the hemodynamic responses to laparoscopic colectomy in pigs

Comparison of intraabdominal pressures using the gastroscope and laparoscope for transgastric surgery

The effectiveness of intravenous dexmedetomidine on perioperative hemodynamics, analgesic requirement, and side effects profile in patients undergoing laparoscopic surgery under general anesthesia

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