2006, Number 2
Hypertension induced by pneumoperitoneum and its treatment with dexmedetomidine
Núñez-Bacarreza JJ, Pórtela-Ortiz JM, Magro-Ibáñez E, García-Hernández L, Cabrera-Jardines R, Alarcón-Rodríguez J
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Language: Spanish
References: 8
Page: 70-73
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ABSTRACT
Introduction: During laparoscopic surgery, CO2-induced pneumoperitoneum may cause hypertension (CO2-HT), which should not be mistaken for an inadequate anesthetic plane. If a monitor for hypnotic depth is not used, the usual reaction is giving more anesthetic, whereas the right intervention should be the use of a vasodilator. Dexmedetomidine is an alpha-2-adrenergic agonist with a wide range of pharmacological properties; it has a short half-life and a quick onset. Dexmedetomidine provides sedation and reduces blood pressure, heart rate, and plasmatic levels of catecholamines without causing respiratory depression or a decrease in cardiac output. Objectives: To determine the incidence of hypertension associated to pneumoperitoneum during laparoscopic surgery in the supramesocolic region, and the effectiveness of dexmedetomidine to control it. Methods: One hundred patients undergoing supramesocolic laparoscopic surgery, ASA I-II, ages 18 to 65, were studied prospectively for intraoperative hypertension and treated with dexmedetomidine. Anesthetic management and monitoring were standardized. Results: Thirty four percent of patients developed CO2-HT. Statistical analysis revealed a correlation between body mass index and development of hypertension. In 97% of cases, hypertension control was achieved with the loading dose of dexmedetomidine. Conclusions: Hypertension associated to pneumoperitoneum is common, even in patients with an adequate hypnotic plane. Dexmedetomidine is a useful drug to control this type of hypertension.REFERENCES