[Circulatory and respiratory effects of celioscopy in the obese]

Hemodynamic and respiratory variations were measured in ten obese women scheduled for laparoscopy. Peritoneal insufflation was associated with a decreased cardiac index (from 2.80 to 2.26 1 X min-1 X m-2; p less than 0.01) and increased systemic vascular resistances (from 1,230 to 1,940 dyn X s X cm-5). Heart rate remained stable (from 85 to 86 c X min-1). Mean arterial pressure was increased (from 86 to 104 mmHg; p less than 0.01). Placing the patients in Trendelenburg's position was associated with a small increase in cardiac index (from 2.26 to 2.49 l X min-1 X m-2; p less than 0.05). Under controlled ventilation, Paco2 was slightly increased (from 26 to 30 mmHg; p less than 0.01). A decrease in venous return due to intraperitoneal vascular compression explained the decrease in cardiac output. The rise in PaCO2 could be explained by CO2 reabsorption from the peritoneal cavity, and also by a change in the ventilation/perfusion ratio due to the curarization, mechanical ventilation and increased abdominal pressure. These results did not differ from the data available in non obese patients.