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Updated: May 3, 2026

Deep Neuromuscular Blockade Leads to a Larger Intraabdominal Volume During Laparoscopy
Published on: June 25, 2013
Effect of abdominal insufflation for laparoscopy on intracranial pressure
Tovy Haber Kamine1, Efstathios Papavassiliou2, Benjamin E Schneider1
1Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Importance:
Increased abdominal pressure may have a negative effect on intracranial pressure (ICP). Human data on the effects of laparoscopy on ICP are lacking. We retrospectively reviewed laparoscopic operations for ventriculoperitoneal shunt placement to determine the effect of insufflation on ICP.
Observations:
Nine patients underwent insufflation with carbon dioxide (CO(2)) at pressures ranging from 8 to 15 mm Hg and ICP measured through a ventricular catheter. We used a paired t test to compare ICP with insufflation and desufflation. Linear regression correlated insufflation pressure with ICP. The mean ICP increase with 15-mm Hg insufflation is 7.2 (95% CI, 5.4-9.1 [P < .001]) cm H(2)O. The increase in ICP correlated with increasing insufflation pressure (P = .04). Maximum ICP recorded was 25 cm H(2)O.
Conclusions And Relevance:
Intracranial pressure significantly increases with abdominal insufflation and correlates with laparoscopic insufflation pressure. The maximum ICP measured was a potentially dangerous 25 cm H(2)O. Laparoscopy should be used cautiously in patients with a baseline elevated ICP or head trauma.
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