Cardiodynamic monitoring during laparoscopic cholecystectomy

With increasing success of laparoscopy, the hemodynamic changes associated pneumoperitoneum (PPM) was described using invasive and non-invasive techniques with variable results. In the present study, we have used non-invasive cardiodynamic monitor to investigate the hemodynamic changes during laparoscopic cholecystectomy. Eleven patients who underwent laparoscopic cholecystectomy under general anesthesia were studied. Cardiodynamic monitor (thoracic bioimpedance) was used to investigate the hemodynamic changes. The following parameters were continuously monitored: Heart Rate (HR), mean arterial blood pressure (MAP), cardiac output (CO) and cardiac index (CI). For statistical purpose, five phases were identified: (A), pre-PPM, (B), 2 min post-PPM, (C), 10 min post-PPM, (D), 30 min post-PPM, and (E), after gas deflation. SPSS package, Version 9 was used for statistical analysis of the data obtained. Student's t-test for paired observations was used for comparisons of the mean values of the data obtained, where P <0.05 was considered significant. There was significant change of the mean value of MAP in phases A and C. Also significant CI changes of the mean values was found between stages A and B (P <0.05). The study showed, transient cardiac depression immediately after PPM with partial recovery after ten min, which was associated with increase in MAP.