The Effect of Pneumoperitoneum on Thoracoabdominal Aortic Blood Flow in Laparoscopic Cholecystectomy

Abstract

Background: We performed this study to determine the influence of the administration of pneumoperitoneum on the blood flow of the thoracoabdominal aorta during laparoscopic cholecystectomy (LC). Methods: Ten patients for LC were enrolled in this study. Anesthesia was performed with propofol, fentanyl and rocuronium. Pneumoperitoneum was made by CO2 gas intraperitoneal instillation at an intraperitoneal pressure of 10-12 mmHg. Peak velocity of blood flow in the systolic phase (PV), mean acceleration of blood flow from the start of systole (MA) and systolic flow time corrected for heart rate (FTc), measured by esophageal doppler monitoring (EDM), and heart rate (HR) and mean brachial BP(MBP) were measured 1, 5 and 10 min after the institution of pneumoperitoneum, (T1, T5 and T10) and compared with those before the institution of pnuemoperotoneum (T0). LC was started after recording all measurements and a position change to the reverse-Trendelenberg position. Results: PV, MA, FTc and HR showed no significant change throughout this study, but MBP at T5 and T10 (110.1 18.5 mmHg and 107.8 10.4 mmHg) were significantly higher than at T0 (84.9 12.9 mmHg) (P = 0.002 and 0.005 respectively). Conclusions: The administration of pneumoperitoneum neither changed nor interferenced with abdominal aortic blood flow.