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Cardiovascular changes during laparoscopic cholecystectomy: a study using transoesophageal Doppler monitoring

Published online by Cambridge University Press:  16 August 2006

S. Elliott ,
P. Savill  and
S. Eckersall
S. Elliott
Affiliation:
Department of Anaesthetics, Lister Hospital, Stevenage, Hertfordshire SG1 4AB, United Kingdom Present address: Department of Anaesthesia, St Mary's Hospital, Praed Street, London W2 1NY, United Kingdom
P. Savill
Affiliation:
Department of Anaesthetics, Lister Hospital, Stevenage, Hertfordshire SG1 4AB, United Kingdom
S. Eckersall
Affiliation:
Department of Anaesthetics, Lister Hospital, Stevenage, Hertfordshire SG1 4AB, United Kingdom
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Abstract

A transoesophageal Doppler cardiac output monitor was used to study the cardiovascular changes occurring during laparoscopic cholecystectomy in patients without (group A) or with (group B) a history of cardiovascular disease, i.e. hypertension, ischaemic heart disease or heart failure. Insufflation of the abdomen with carbon dioxide caused significant (P<0.01) falls in mean cardiac index (17.9% in group A, 25.1% in group B) and mean stroke volume index (15.3% in group A, 21.2% in group B). Simultaneously, there was a significant (P<0.05) increase in mean systolic blood pressure (19.4%) in group A. There were no other differences in the cardiovascular responses of the two groups. There was no correlation between systolic blood pressure and either cardiac index or stroke volume index. No significant complications or morbidity were associated with the use of the transoesophageal Doppler monitor. We conclude that the cardiovascular changes associated with insufflation are neither predictable by clinical assessment nor adequately determined by routine monitoring. We recommend the transoesophageal Doppler monitor for use in this situation.

Keywords

laparoscopic cholecystectomytransoesophageal Doppler monitorcardiac index
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 15 , Issue 1 , January 1998 , pp. 50 - 55
Copyright
1998 European Society of Anaesthesiology

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