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Changes in cerebral hemodynamics during laparoscopic cholecystectomy
G De Cosmo1, E Iannace, P Primieri
1Institute of Anaesthesiology and Reanimation, Catholic University of Rome, Italy.
Neurological Research
|November 11, 1999
Summary
Laparoscopic surgery
Area of Science:
- Anesthesiology
- Neurosurgery
- Cardiovascular Surgery
Background:
- Laparoscopic surgery involves CO2 insufflation, potentially affecting cerebral perfusion.
- Cardiovascular and hemogasanalytic changes during laparoscopy can impact brain blood flow.
Purpose of the Study:
- To assess changes in cerebral blood flow velocity during laparoscopic cholecystectomy.
- To correlate hemodynamic alterations with cerebral perfusion during the procedure.
Main Methods:
- Transcranial Doppler ultrasonography monitored middle cerebral artery blood flow velocity.
- Electrical bioimpedance measured cardiac output and stroke volume.
- Non-invasive monitoring of end-tidal CO2, blood pressure, and oxygen saturation.
Main Results:
- Cerebral artery blood flow velocity increased post-CO2 insufflation and peaked after desufflation.
- Significant reductions in stroke volume and cardiac output, with increased systemic vascular resistance, occurred after CO2 insufflation.
- Hemodynamic changes persisted throughout abdominal insufflation, while end-tidal CO2 remained stable.
Conclusions:
- The cerebrovascular system exhibits adaptive changes during laparoscopic surgery.
- Significant cardiovascular and cerebral hemodynamic variations necessitate pre-operative evaluation for patients with vascular disorders.