Effect of pneumoperitoneum on the level of plasma potassium

The purpose of this study was to find out the impact of acute respiratory acidosis on serum potassium level during laparoscopy. The study was performed on ninety patients who underwent laparoscopic surgery. Ventilation parameters were kept constant throughout the study. Samples for assessment of blood gases were collected in the following sequence: before pneumoperitoneum, a the 20[th] minute of pneumoperitoneum, at the 60[th] minute of pneumoperitoneum, and after extubation. The systolic, diastolic pressures and heart rate were recorded simultaneously. Before pneumoperitoneum, heart rate, systolic and diastolic pressures were reduced according to baseline values. With the induction of pneumoperitoneum, both systolic and diastolic pressures returned to the baseline levels except the heart rate. There was a statistically significant increase in potassium level [Control: 3.49 mEq.L[-1], determined high level:3.75mEq.L[-1]]. Electrolytes, especially potassium, should be monitored during laparoscopy utilizing CO[2] pneumoperitoneum and when necessary, ventilatory parameters should be adjusted

Diazepam serum concentration-sedative effect relationship in patients with liver disease

Sedative effects and drug elimination characteristics after intravenous bolus administration of diazepam 0.15 mg/kg were investigated in 15 patients with liver disease [Group I], and in 15 normal patients [Group II] during diagnostic laparoscopy. Diazepam induced heavier sedation in patients with liver disease [p < 0.02]. Serum concentration of diazepam 30 minutes after administration was significantly lower in Group I [group with liver disease] when compared with Group II [control group] [210.68 +/- 112.65 ng/ml vs 451.57 +/- 239.87 ng/ml, p < 0.02]. The sedation scores during the laparoscopy procedures correlate negatively with serum benzodiazepine levels. The benzodiazepine concentration-time profiles of the groups vary significantly [p < 0.02]. Heavier sedative effect and lower benzodiazepine concentrations in patients with liver diseases suggests that the permeability of blood brain barrier increases and that higher affinity to benzodiazepine receptors exists. Differences in concentration-time courses of diazepam in patients with liver diseases is a warning indicating the accumulation of drug when infused or used frequently