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2017, Number 3

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Acta Med 2017; 15 (3)

Correlation between direct medical intraabdominal measurements with the CO2 insufflation pressure in laparoscopic surgery

Silva SL, Rodríguez ZDL, Elizalde FF, Rendón MME

Language: Spanish
References: 18
Page: 194-199
PDF size: 320.50 Kb.


ABSTRACT

Introduction: An intraabdominal pressure less than 14 mmHg is fundamental to avoid hemodynamic alterations during laparoscopic procedures. The monitoring by insufflation pressure (InfP) may not be the most reliable. Objective: To compare the InfP values with those measured directly in the abdominal cavity (IAP), and to establish their correlation with hemodynamic variations. Material and methods: During eight laparoscopic procedures, we obtained InfP and IAP measures simultaneously: at baseline and every five minutes until the suspension of the pneumoperitoneum. All procedures were under general anesthesia and deep and/or intense neuromuscular blockage. We analyzed the hemodynamic stability (heart rate, arterial pressure and peripheral oxygen saturation) with the InfP and IAP measures. Results: We analyzed 54 pair measures. The correlation between measures was 0.86 (p ‹ 0.001, R2 = 0.74). Fifteen measures (27.8%) were equal; in 59.3% IAP › InfP, and in 14.1% IAP ‹ InfP. The variations of IAP ≥ 14 mmHg were associated with arterial hypertension and tachycardia, while IAP ≤ 11 mmHg were associated with low diastolic arterial pressures and low heart rate (‹ 60). Conclusions: The monitoring of the intra-abdominal pressure with InfP may not be reliable, so we recommend a direct measurement.


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