Key result
Laparoscopic abdominal surgery was associated with 10-25% lower pulse transit time values compared to open abdominal surgery (P < 0.001).
Why the study?
Does laparoscopic abdominal surgery compared to open abdominal surgery affect pulse transit time and mean arterial pressure in healthy female patients?
Observational (n=30)
No
Does laparoscopic abdominal surgery compared to open abdominal surgery affect pulse transit time and mean arterial pressure in healthy female patients?
Effect estimate: 10-25% lower
p-value: p=<0.001
Pulse transit time is shorter during laparoscopic compared to open abdominal surgery, likely reflecting higher sympathetic tone or increased intra-abdominal pressure, though it is not a reliable beat-to-beat marker for blood pressure.
Shorter PTT during laparoscopy cautions against its use as a BP surrogate; leaves open mechanisms of sympathetic activation or intra-abdominal pressure.
Background: The pulse transit time (PTT) is the time interval between the R-wave of the ECG and the appearance of the pulse wave in the periphery during the same cardiac cycle. PTT is influenced by various factors including sympathetic tone and vascular compliance. The authors assessed the effect of anesthesia, intubation and laparoscopic (LPS) versus laparotomic (LPT) surgery on PTT. Methods: PTT, mean arterial blood pressure (MAP) and heart rate (HR) were measured during induction of anesthesia and during the first 45-min of LPS ( n = 17) and LPT ( n = 13) surgery in a group of female patients. Results: Anesthesia increased PTT values, while painful stimuli caused an immediate reduction. During surgery, we observed group effects on PTT and MAP with 10-25% lower PTT values (P < 0.001) and 15-30% greater MAP values (P < 0.01) in the LPS group. HR did not differ between groups. Conclusions: The pulse transit time was used successfully to track the effect of anesthesia and stressful nociceptive stimuli during induction of anesthesia. The shorter PTT values during laparoscopic abdominal surgery compared to open abdominal surgery suggest a higher sympathetic tone in patients undergoing laparoscopic surgery and/or an effect of the increased abdominal pressure on PTT.
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Sigtermans et al. (2008) conducted an observational in Elective abdominal surgery (n=30). Laparoscopic abdominal surgery vs. Open abdominal surgery (laparotomy) was evaluated on Pulse transit time (PTT) (10-25% lower, p=<0.001). Laparoscopic abdominal surgery was associated with 10-25% lower pulse transit time values compared to open abdominal surgery (P < 0.001).
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