British Journal of Anaesthesia, 1972, Vol. 44, No. 11 1155-1162
© 1972 The Board of Management and Trustees of the British Journal of Anaesthesia
research-article |
CARDIAC OUTPUT AND ARTERIAL BLOOD-GAS TENSION DURING LAPAROSCOPY
Department of Physiology, University of Aberdeen
Department of Obstetrics and Gynaecology
Department of Anaesthetics
Department of Obstetrics and Gynaecology
Department of Anaesthetics, Abardeen Royal Infirmary Scotland
We have measured, in 21 horizontal and 18 25° head-down anaesthetized, artificially ventilated patients, the effea of progressive increases of intra-abdominal pressure (IAP) before, during and after laparoscopy, on: CVP, intrathoracic pressure (ITP), femoral venous pressure (FVP), cardiac output (Q), heart rate, mean arterial blood pressure (MAP), peak airway pressure, FF/QO, and arterial blood-gas tensions. FVP paralleled the increase of IAP. In both horizontal and tilted patients increases of IAP to around 20 cm H,0 were accompanied by increases of CVP (horizontal: 4.6 cm H3O; tilted: 10.2 cm H,O), by smaller increases of ITP (horizontal: 1.8 cm 11,0; tilted: 32 cm H,O), and by increases of Q (from 3.9 l./min per 70 kg to 5.0 l./min per 70 kg in horizontal position; and from 4.8 L/min per 70 kg to 5.3 L/min per 70 kg in tilted patients). Greater increases of IAP to around 40 cm HjO were accompanied by falls of CVP and Cj (to 4.4 l./min per 70 kg in both positions), accompanied by parallel changes of MAP and by moderate tachycardia. There was no arterial hypoxaemia, Pao* rising from 132.0 mm Hg to 135.4 mm Hg in the horizontal patients, and from 151.3 mm Hg to 155.2 mm Hg in the tilted patients; increases of Paoo3 were slight (from 28.6 mm Hg to 32.4 mm Hg in the horizontal patients, and from 25.3 to 30.9 mm Hg in the tilted patients).
*Department of Anaesthetics, Toronto General Hospital, Toronto, Ontario, Canada
Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario, Canada
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