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Intracranial blood flow during laparoscopic hysterectomy
P Kirkinen1, E Hirvonen, M Kauko
1Department of Obstetrics and Gynecology, University of Kuopio, Finland.
Aim Of The Study:
To examine intracranial blood flow during major laparoscopic gynecologic operation and the effects of a deep Trendelenburg position and pneumoperitoneum on the flow.
Material:
Fifteen patients scheduled for laparoscopic hysterectomy.
Methods:
Trans-cranial Doppler examination of blood flow velocity waveforms in the middle cerebral artery during operation.
Results:
Trendelenburg position and pneumoperitoneum were followed by a decrease in cardiac output and an increase of central venous pressure and pulmonary capillary wedge pressure. No significant changes in the pulsatility index or maximal or mean blood flow velocities in the middle cerebral artery occurred during operations. A negative correlation between percentual changes in the pulsatility index and mean arterial pressure existed.
Conclusions:
Uncomplicated laparoscopic hysterectomy is not associated with harmful changes in intracranial circulation in spite of a Trendelenburg position, pneumoperitoneum and changes in the patient's extracranial hemodynamics.