Laparoscopy: a triad of stressful manoeuvre

ABSTRACT

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