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Improving the adverse changes in cardiac autonomic nervous control during laparoscopic surgery, using an intermittent
Amitai Bickel1, Malka Yahalom, Nathan Roguin
1Department of Surgery, Western Galilee Hospital, Nahariya, Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel. amitai@netvision.net.il
American Journal of Surgery
|January 7, 2004
Summary
Pneumoperitoneum during laparoscopic surgery can harm the heart. Using a compression device on lower limbs improved cardiac autonomic control by boosting parasympathetic activity, potentially benefiting patients with heart conditions.
Area of Science:
- Cardiovascular Physiology
- Autonomic Nervous System Regulation
- Surgical Anesthesia
Background:
- Positive pressure pneumoperitoneum (PP) during laparoscopic surgery can cause adverse cardiovascular effects and increase sympathetic cardiac activity.
- These effects may have serious consequences, particularly for patients with pre-existing cardiac conditions.
Purpose of the Study:
- To investigate whether intermittent sequential pneumatic compression of the lower extremities could reverse hemodynamic effects and improve cardiac autonomic control during laparoscopic surgery.
- To assess the impact of Lympha-press on heart rate variability and sympathetic/parasympathetic activity.
Main Methods:
- A prospective cohort study involving 15 patients undergoing laparoscopic cholecystectomy, serving as their own controls.
- Cardiac autonomic nervous system activity was assessed using spectral analysis of heart rate variability (HRV) via fast Fourier transformation.
- Measurements were compared during anesthesia, PP, and PP with Lympha-press activation.
Main Results:
- Positive pressure pneumoperitoneum (PP) led to increased sympathetic activity, indicated by higher power in the low-frequency band of HRV.
- Activation of the Lympha-press compression device resulted in increased parasympathetic activity, evidenced by a significant rise in the high-frequency band power.
Conclusions:
- Intermittent sequential pneumatic compression may enhance cardiac autonomic control during laparoscopic surgery by promoting parasympathetic activity.
- This intervention could be clinically significant for patients with cardiac disease, improving heart rate variability and potentially reducing the risk of ventricular arrhythmias.