Key result
Intra-abdominal pressure above 15 mmHg significantly affected hemodynamics during laparoscopic cholecystectomy, whereas pressures of 13-15 mmHg did not influence hemodynamics significantly.
Why the study?
During laparoscopic procedures, hemodynamic stability is of great concern.
Does higher intra-abdominal pressure affect hemodynamic parameters in patients undergoing laparoscopic cholecystectomy?
RCT (n=90)
Randomly allocated
Does higher intra-abdominal pressure affect hemodynamic parameters in patients undergoing laparoscopic cholecystectomy?
Maintaining intra-abdominal pressure between 10-15 mmHg during laparoscopic cholecystectomy is relatively safe and preserves hemodynamic stability compared to pressures above 15 mmHg.
IAP >15 mmHg may worsen hemodynamics during laparoscopic cholecystectomy; leaves open optimal pressure thresholds in patients with cardiac compromise.
Background and Aims: During laparoscopic procedures, hemodynamic stability is of great concern. This study was carried out to evaluate hemodynamic Changes with different intra- abdominal pressure (IAP) for laparoscopic cholecystectomy using Advanced Cardiac Output (FloTrac) Monitoring. Materials and Methods: In this Prospective, randomized and observational study, total 90 patients ASA grade I, II scheduled for laparoscopic cholecystectomy were randomly allocated to three groups: Group I :10-12mm hg, groupII-13-15mmhg, Group III- > 15mmhg. Central venous line and arterial cannula was secured before induction and connected to FloTrac monitor. Heart rate (HR), Cardiac index (CI), Systemic vascular resistance index (SVRI), Stroke volume variation (SVV), Oxygen saturation (SPO2) were monitored at various interval. For Statistical analysis student t-test and ANOVA test were used. Results: At all time intervals, HR of Group I was found to be lower than Group II and Group III except at insufflation. CI (Cardiac Index) of Group I was also found to be lower than that of Group II and that of Group III was lower than that of Group II at all time intervals. At all time periods values of SVRI, SVV of Group I were found to be lower than that of Group II and Group III. SVRI, SVV of Group II were found to be lower than that of Group III. Conclusions: IAP value above 15mm Hg seems to affect the hemodynamics significantly. Study showed that the IAP rise from 10-12 to 13-15 does not influence hemodynamics significantly, and could be adjudged relatively safe.
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Biswas et al. (2020) conducted an RCT in Laparoscopic cholecystectomy (n=90). Intra-abdominal pressure (IAP) >15 mmHg or 13-15 mmHg vs. IAP 10-12 mmHg was evaluated on Hemodynamic changes (HR, CI, SVRI, SVV, SPO2). Intra-abdominal pressure above 15 mmHg significantly affected hemodynamics during laparoscopic cholecystectomy, whereas pressures of 13-15 mmHg did not influence hemodynamics significantly.
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