Cardiodynamic monitoring during laparascopic cholecystectomy

ABSTRACT

With increasing success of laparoscopy, the hemodynamic changes associated pneumoperitoneum [PPM] was described using invasive and non-invasive techniques with variable results. In the present study, we have used non-invasive cardiodynamic monitor to investigate the hemodynamic changes during laparoscopic cholecystectomy. Eleven patients who underwent laparoscopic cholecystectomy under general anesthesia were studied. Cardio dynamic monitor [thoracic bio- impedance] was used to investigate the hemodynamic changes. The following parameters were continuously monitored Heart Rate [HR], mean arterial blood pressure [MAP], cardiac output [CO] and cardiac index [CI]. For statistical purpose, five phases were identified [A], pre-PPM, [B], 2 min post-PPM, [C], 10 min post- PPM, [D], 30 min post-PPM, and [E], after gas deflation. SPSS package, Version 9 was used for statistical analysis of the data obtained. Student's t-test for paired observations was used for comparisons of the mean values of the data obtained, where P <0.05 was considered significant. There was significant change of the mean value of MAP in phases A and C. Also significant CI changes of the mean values was found between stages A and B [P <0.05]. The study showed, transient cardiac depression immediately after PPM with partial recovery after ten min, which was associated with increase in MAP