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Plasma catecholamine responses during laparoscopic gynecologic surgery with CO(2) insufflation
B Ishizuka1, Y Kudo, A Amemiya
1Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae, Kawasaki, Kanagawa, Japan 216-8155.
Study Objective:
To compare adrenergic-sympathetic responses during pelvic laparoscopic surgery with CO(2) insufflation with those during laparotomy. DESIGN. Prospective study (Canadian Task Force classification II-1).
Setting:
Tertiary care university hospital.
Patients:
Twenty-one infertile women with a clinical diagnosis of endometriosis.
Intervention:
Plasma norepinephrine (NE) and epinephrine (E) levels were measured in patients undergoing laparoscopic or open pelvic surgery.
Measurements And Main Results:
During laparoscopic surgery, increases in NE and E levels were correlated with arterial tension of CO(2) (PaCO(2)) and were greater in patients with a larger increase in PaCO(2) than in those undergoing laparotomy. Hemodynamic changes were also more evident during laparoscopic surgery, with larger PaCO(2) increases.
Conclusion:
The PaCO(2) increases due to CO(2) insufflation are associated with adrenergic-sympathetic activation and hemodynamic changes during laparoscopic pelvic surgery.