[PECULIARITIES OF CARBOPNEUMPEROPERITONEUM AT LAPAROSCOPIC OPERATION UNDER CONDITIONS OF RHYTHM DISORDERS AND...

Area of Science:

• Cardiology
• Minimally Invasive Surgery
• Anesthesiology

Background:

• Laparoscopic surgery utilizes carbopneumoperitoneum, which can impact cardiac function.
• Patients with pre-existing cardiac rhythm disorders and conduction disturbances present unique challenges during surgery.
• Understanding the effects of intra-abdominal pressure on the heart is vital for patient safety.

Purpose of the Study:

• To investigate the influence of carbopneumoperitoneum on the occurrence and types of cardiac arrhythmias during laparoscopic surgery.
• To assess the risk stratification of cardiac events based on the complexity of laparoscopic procedures.
• To identify key factors influencing intraoperative cardiac complications in patients undergoing laparoscopic surgery.

Main Methods:

• Analysis of 940 patients undergoing laparoscopic surgery, divided into groups based on pre-existing arrhythmias and those developing them during surgery.
• Detailed recording and analysis of various cardiac rhythm disturbances, including tachycardia, bradycardia, extrasystoles, and heart blocks.
• Assessment of QT interval dispersion as an indicator of cardiac electrophysiological changes.
• Correlation of arrhythmia incidence with surgical procedure risk levels (low, medium, high).

Main Results:

• Carbopneumoperitoneum significantly increases the risk of sinus bradycardia (up to 26.5%), ventricular extrasystoles (31.0%), and supraventricular extrasystoles (15.2%).
• Higher risk procedures are associated with a greater incidence of potentially malignant arrhythmias like unstable ventricular tachycardia and "pirouette" tachycardia.
• Increased risk of AV blockades (Mobitz II and complete AV block) observed in high-risk laparoscopic surgeries.
• QT interval dispersion increases with surgical risk, indicating heightened electrophysiological instability.

Conclusions:

• Laparoscopic surgery with carbopneumoperitoneum poses a significant risk for cardiac arrhythmias, especially in patients with pre-existing conditions.
• Risk stratification of laparoscopic procedures is essential for anticipating and managing potential cardiac events.
• Antiarrhythmic treatment and careful consideration of intraoperative intra-abdominal pressure are recommended for patients undergoing high-risk laparoscopic surgery.