Laparoscopy: a triad of stressful manoeuvre

The effects of diagnostic laparoscopic procedure on plasma cortisol, blood glucose and lactate levels were studied in ten females. They received N2O-O2 mixture [66%] supplimented by 0.5-l% halothane under controlled mechanical hyperventillation. The mean blood glucose level was significantly increased after induction [P<0.05] and remained high during the subsequent periods [P<0.005]. The mean plasma cortisol concentration increased significantly from 371 to 430 m mol/L [P<0.05] immediately after unsufflation. It remained significantly high, till the end of the procedure [P<0.00l]. Their were no significant changes in the mean values of blood lactate during the whole procedure. The mean blood pressure and heart rate were increased during the periods of raised plasma cortisol levels [P< 0.001,< 0.005]. The mean PaCO2 level during the two min. of insufflation did not show significant change from the pre-inflation hypocapnic period. The mechanical effect of CO2 inflation could be considered as a third major stressful factor during laparoscopy. This was added to the stressful factors of surgery and anaesthesia as well as the neurohormonal metabolic responses of the highly absorbed CO2 from the peritoneal cavity

new soluble acetylsalicylic acid derivative for postoperative pain relief

Immediate postoperative pain relief was assessed in 30 patients, to evaluate the analgesic and side effects of Lysine acetyl-salicylate [L.A.S.] in comparison to pethidine. Assessment of pain relief was done objectively using dolorimetry and subjectively by patients questionare. Also, haemodynamic and blood gases monitoring and recording of side effects was performed. It was found that L.A.S. is less potent as analgesic relative to pethidine, producing no changes in the haemodynamics, no drowsiness, nauzia or vamiting, but increases bleeding and coagulation times. It is recommended to give L.A.S. when the pain is mild or moderate or when respiratory depression is a high risk