Hemodynamic, respiratory, and metabolic effects of laparoscopic cholecystectomy

Goodale, Robert L.; Beebe, David S.; McNevin, M P; Boyle, Michael; Letourneau, J G; Abrams, Jerome H.; Cerra, Frank B.

doi:10.1016/s0002-9610(05)81148-1

Cited by 100 publications

(51 citation statements)

References 19 publications

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“…Surgery therefore results in a distinct pattern of influence on the immune system, parts of which are rapidly becoming better understood. So far, it is clear that the predominant defect is the T-cell response, and that cytokines play an important role in its origin [75]. …”

Section: Cytokine Response To Abdominal Surgerymentioning

confidence: 99%

“…The advantages, as well as the disadvantages and risks of laparoscopic surgery as compared with open abdominal surgery, have been extensively discussed in recent years [75, 76]. Several investigators have suggested that the explanation of why laparoscopic surgery results in less postoperative pain and infectious complications is that it reduces the tissue trauma so implicating less local cytokine production.…”

Section: Comparison Of Cytokine Levels In Conventional Versus Minimalmentioning

confidence: 99%

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Cytokines in Surgical Trauma: Cholecystectomy as an Example

et al. 1998

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Interleukin-1 (IL-1), tumor necrosis factor and particularly IL-6 are potent mediators of the immune and acute phase response caused by surgery and trauma. Their production can be reduced by steroids, nonsteroidal anti-inflammatory agents, nitric oxide and anti-inflammatory cytokines such as IL-4, IL-10 and IL-13. Some of the benefits of minimal invasive surgery may be due to lower cytokine levels in these procedures compared to those of conventional surgery, although this is but one factor that should be taken into account. Therefore, all surgical procedures that cause a lower systemic cytokine response are to be favored if other effects and the side effects of the surgery are equal.

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Section: Cytokine Response To Abdominal Surgerymentioning

confidence: 99%

Section: Comparison Of Cytokine Levels In Conventional Versus Minimalmentioning

confidence: 99%

Cytokines in Surgical Trauma: Cholecystectomy as an Example

et al. 1998

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“…In fact, during abdominal CO2 insufflation, the measured pressure in the femoral veins is increased with reduced flow velocity indicating decreased venous return from the lower extremities. 12 The cephalad shift of the diaphragm due to abdominal distention will increase pleural pressure, which will, in turn, be partially transmitted to the cardiac chambers causing an increase in cardiac f'tlling pressures (CVP, PAOP). The increased PAOP and reduced CI do not represent cardiac dilatation since ventricular volumes measured by transoesophageal eehography (TEE) in healthy patients 4 are not increased.…”

Section: Increased Abdominal Pressurementioning

confidence: 99%

Cardiopulmonary function and laparoscopic cholecystectomy

1995

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“…These physiological changes, can be detrimental especially in elderly and haemodynamically compromised patients. 19,20 Various techniques and pharmacological agents have been used to counteract these detrimental effects of pneumoperitoneum. 21 Clonidine, a centrally acting alpha-2 adrenergic agonist, which was first introduced into clinical practice as an antihypertensive medication, has been recently used for anaesthetic premedication, providing sedative, anxiolytic, and analgesic effects.…”

Section: Discussionmentioning

confidence: 99%

Comparative clinical study of the effect of oral clonidine premedication on intraoperative haemodynamics in the patients undergoing laparoscopic cholecystectomy

Kotwani

Kamdar

2017

Int Surg J

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Background: Pneumoperitoneum created during laparoscopy results in patho-physiologic changes, especially in the cardiovascular system. Clonidine diminishes stress response by reducing circulating catecholamines and hence increases perioperative circulatory stability in patients undergoing laparoscopic surgeries. This comparative clinical study was planned compare with controls the effects of oral clonidine premedication (150 micrograms) on the intraoperative haemodynamics during laparoscopic cholecystectomy.Methods: Sixty adult patients between 15-50 years, scheduled for laparoscopic cholecystectomy under general anaesthesia were enrolled in the study. The patients were randomly assigned to two study groups of 30 patients each, Group CL: received oral clonidine (150 microgram) 90 minutes before induction of anaesthesia and Group C: received placebo. Anaesthetic technique was same for both the study groups. Hemodynamic variables (Heart rate, systolic (SBP), diastolic (DBP), mean arterial pressure (MAP), and EtCO2 were recorded at specific times - baseline; 90 minutes following study drug administration; induction of anaesthesia; 5 and 10 minutes following intubation; At skin incision; after creation of CO2 pneumoperitoneum and every 15 minutes thereafter till end of surgery; after desufflation; 5 minutes following extubation.Results: Patients in clonidine group had lower HR, SBP and DBP values as compared to control group at all points of time after giving the study drug (P <0.05). Percent change from baseline in HR and Blood pressure at different points of time was significantly high in control group than in clonidine group.Conclusions: Oral clonidine premedication (150 micrograms) is safe and provides perioperative hemodynamic stability in ASA I and II patients undergoing laparoscopic cholecystectomy, and hence can be recommended as a routine premedication for laparoscopic procedures.

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Hemodynamic, respiratory, and metabolic effects of laparoscopic cholecystectomy

Cited by 100 publications

References 19 publications

Cytokines in Surgical Trauma: Cholecystectomy as an Example

Cytokines in Surgical Trauma: Cholecystectomy as an Example

Cardiopulmonary function and laparoscopic cholecystectomy

Comparative clinical study of the effect of oral clonidine premedication on intraoperative haemodynamics in the patients undergoing laparoscopic cholecystectomy

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