Laparoscopic colecistectomy: anestesthetic implications in the elderly patient

A Paratore,L Ferrigno,V Minutolo,G Buscema,O Minutolo

doi:10.1186/1471-2318-10-s1-a112

Abstract

BackgroundThe gallbladder stone is 20-40% of geriatric diseases. Inelderly patients with limited cardiac reserve the pneu-moperitoneum determines dangerous alterations of thecardiac output and other hemodynamic variables. Thefrequent co-morbidity in elderly people leads to a severeprognosis in these patients with surgical high mortalityand morbidity rates in open surgery (1) otherwise thelaparoscopic procedure is followed by lower mortalityand morbidity rates (0-0.6% vs 1.4%). (2,3,4). The gra-dual abdominal insufflation to 12 mmHg followed by alimited 10 degree head-up tilt is associated with cardio-vascular stability in elderly ASA III patients (5).The aim of our study was to analyze hemodynamicmodifications during surgical treatment by laparoscopiccolecistectomy and the anesthetic implications.Materials and methods121 patients aged over 65 years old were analyzed whounderwent laparoscopic cholecistectomy . The operationwas conducted with a low pressure of CO2 (8-10mmHg).We observed the hemodynamic trend duringthe anesthesia: blood pressure, heart rate, respiratoryrate, Tidal Volume and end Tidal C0

Highlights

The gallbladder stone is 20-40% of geriatric diseases
Materials and methods 121 patients aged over 65 years old were analyzed who underwent laparoscopic cholecistectomy
The operation was conducted with a low pressure of CO2 (8-10 mmHg).We observed the hemodynamic trend during the anesthesia: blood pressure, heart rate, respiratory rate, Tidal Volume and end Tidal C02

Summary

Background

The gallbladder stone is 20-40% of geriatric diseases. In elderly patients with limited cardiac reserve the pneumoperitoneum determines dangerous alterations of the cardiac output and other hemodynamic variables. The frequent co-morbidity in elderly people leads to a severe prognosis in these patients with surgical high mortality and morbidity rates in open surgery [1] otherwise the laparoscopic procedure is followed by lower mortality and morbidity rates (0-0.6% vs 1.4%). The gradual abdominal insufflation to 12 mmHg followed by a limited 10 degree head-up tilt is associated with cardiovascular stability in elderly ASA III patients [5]. The aim of our study was to analyze hemodynamic modifications during surgical treatment by laparoscopic colecistectomy and the anesthetic implications

Materials and methods

Results

Conclusions