Ventilatory effects of laparoscopic cholecystectomy

Burés, Enric; Fusciardi, J.; Lanquetot, H.; Dhoste, K.; Richer, Jean; Lacoste, L.

doi:10.1111/j.1399-6576.1996.tb04489.x

Cited by 23 publications

(12 citation statements)

References 17 publications

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“…Head up position also increases the risk of regurgitation, silent aspiration and peripheral nerve injuries. [9][10][11][12][13][14][15] All these patho-physiological changes of laparoscopic procedures complicate the anesthetic management. So, the anesthesiologists must have a thorough understanding of these changes so that he is always prepared to prevent, detect and treat the possible alterations that can occur during the surgical procedures.…”

Section: Discussionmentioning

confidence: 99%

Anesthesia for Laparoscopic Cholecystectomy: Experience with 5000 Cases

Bhattarai¹,

Sulaimankulov²,

Dangi³

et al. 2016

AIMDR

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Background: Since the introduction of laparoscopic cholecystectomy in 1987 by Philips Mouret its popularity has increased tremendously and very rapidly because of its several advantages. But reports of randomized large control seriesare not yet available so we plan to report our experience of 5000 cases of single incision laparoscopic cholecystectomies and their anesthetic management. Objective: The purpose of this retrospective study was to evaluate the general anesthetic technique for laparoscopic cholecystectomy keeping in mind the pathophysiological effect of laparoscopy, head up position and pneumoperitoneum. Methods: A retrospective study of 5000 cases of symptomatic gall bladder disease that underwent laparoscopic cholecystectomy at Nobel Medical College Teaching Hospital, Nepal from Jan 2010-Dec 2015 was done. Detail pre-anesthetic check up, investigation, preparation and anesthetic techniques were carried out as per hospital protocol. Strict vigil was made to maintain the vital parameters within normal limit particularly ETCO2 below 35 mmHg. All efforts were made to keep ETCO2 below 35mHg. At the end of surgery residual neuromuscular blockade was reversed with neostigmine and glycopyrrolate, before they were transferred to PACU. Results: The mean age of the patients was 48 years with a male:female of 1:2.26. 28.64 % of patients belonged to ASA III. More than 95 % patients maintained SPO2 between 98-100% and 91% maintained their ETCO2 below or around 35 mmHg. Intra-operative surgical and anesthetic complications were controlled with proper therapies. There was no intra-operative death. Conclusion: Single incision laparoscopic Cholecystectomy (SILC) is a safe, cost effective ideal for day care surgery and general anesthesia with controlled mechanical ventilation with oxygen, air, fentanyl, isoflurane, midazolam and vecuronium/atracurium is good choice.

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Section: Discussionmentioning

confidence: 99%

Anesthesia for Laparoscopic Cholecystectomy: Experience with 5000 Cases

Bhattarai¹,

Sulaimankulov²,

Dangi³

et al. 2016

AIMDR

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“…This procedure needs to ensure optimal perioperative analgesic control with motor blockade during surgery associated with a rapid postoperative recovery. In our laboratory, we have developed epidural anesthesia techniques in pigs [76] which allow us to conduct pharmacological and pathophysiological studies [77, 78]. …”

Section: Different Models For Renal Transplantation and Ischemia-rmentioning

confidence: 99%

Contribution of Large Pig for Renal Ischemia‐Reperfusion and Transplantation Studies: The Preclinical Model

Giraud

Favreau

Chatauret

et al. 2011

BioMed Research International

157

144

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Animal experimentation is necessary to characterize human diseases and design adequate therapeutic interventions. In renal transplantation research, the limited number of in vitro models involves a crucial role for in vivo models and particularly for the porcine model. Pig and human kidneys are anatomically similar (characterized by multilobular structure in contrast to rodent and dog kidneys unilobular). The human proximity of porcine physiology and immune systems provides a basic knowledge of graft recovery and inflammatory physiopathology through in vivo studies. In addition, pig large body size allows surgical procedures similar to humans, repeated collections of peripheral blood or renal biopsies making pigs ideal for medical training and for the assessment of preclinical technologies. However, its size is also its main drawback implying expensive housing. Nevertheless, pig models are relevant alternatives to primate models, offering promising perspectives with developments of transgenic modulation and marginal donor models facilitating data extrapolation to human conditions.

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“…The respiratory effects are limited. A 15–25% rise in expired CO 2 volume, due to CO 2 diffusion through peritoneal capillary vessels, without any change in dead space volume and alveolar ventilation, is observed (5). Similarly, a 15–20% rise in P a CO2 and P E' CO2 usually occurs.…”

mentioning

confidence: 99%

Pigs are not a reliable experimental model in the study of the haemodynamic and respiratory effects of CO₂ pneumoperitoneum

Richard

Burés

Lacoste

et al. 2002

Acta Anaesthesiol Scand

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Ventilatory effects of laparoscopic cholecystectomy

Abstract: We conclude that only exogenous CO2 loading, and not VA, can explain such increase in FETCO2 and FaCO2, in cases of limited CO2 insufflating pressure in ASA 1-2 patients.

Cited by 23 publications

References 17 publications

Anesthesia for Laparoscopic Cholecystectomy: Experience with 5000 Cases

Anesthesia for Laparoscopic Cholecystectomy: Experience with 5000 Cases

Contribution of Large Pig for Renal Ischemia‐Reperfusion and Transplantation Studies: The Preclinical Model

Pigs are not a reliable experimental model in the study of the haemodynamic and respiratory effects of CO₂ pneumoperitoneum

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Ventilatory effects of laparoscopic cholecystectomy

Abstract: We conclude that only exogenous CO2 loading, and not VA, can explain such increase in FETCO2 and FaCO2, in cases of limited CO2 insufflating pressure in ASA 1-2 patients.

Cited by 23 publications

References 17 publications

Anesthesia for Laparoscopic Cholecystectomy: Experience with 5000 Cases

Anesthesia for Laparoscopic Cholecystectomy: Experience with 5000 Cases

Contribution of Large Pig for Renal Ischemia‐Reperfusion and Transplantation Studies: The Preclinical Model

Pigs are not a reliable experimental model in the study of the haemodynamic and respiratory effects of CO2 pneumoperitoneum

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Product

Resources

About

Pigs are not a reliable experimental model in the study of the haemodynamic and respiratory effects of CO₂ pneumoperitoneum