Korean J Anesthesiol.  2008 Dec;55(6):662-665. 10.4097/kjae.2008.55.6.662.

The effect of carbon dioxide pneumoperitoneum on baroreflex sensitivity

• Chung S
• Cho H
• Kim KO
• Lee Y
• Choi JG
• In J
• Choe YS

• KMID: 1782538
• DOI: http://doi.org/10.4097/kjae.2008.55.6.662

Abstract

BACKGROUND: To determine if positive pressure pneumoperitoneum has adverse effects on autonomic nervous system function, we examined baroreflex sensitivity (BRS) during carbon dioxide pneumoperitoneum in patients undergoing laparoscopic surgery.
METHODS
Twenty adult patients scheduled for laparoscopic gynecologic surgery were selected for the study. After general anesthesia was induced with sevoflurane, continuous electrocardiography and blood pressure were monitored. Spontaneous BRS was achieved using sequence method immediately before, and 5 minutes after, pneumoperitoneum. Heart rate variability (HRV) was also determined.
RESULTS
After pneumoperitoneum, BRS decreased from 12.9 +/- 1.8 ms/mmHg to 8.1 +/- 1.1 ms/mmHg (P < 0.05), and the power of the high frequency band decreased from 237.8 ms2/Hz to 49.6 ms2/Hz (P < 0.05).
CONCLUSIONS
Compared to recordings obtained before pneumoperitoneum, BRS was decreased during pneumoperitoneum. This may predispose patients undergoing laparoscopic surgery to hemodynamic instability in addition to pneumoperitoneum itself.

Keyword

autonomic nervous system; baroreflex sensitivity; carbon dioxide; laparoscopy; pneumoperitoneum

MeSH Terms

Adult
Anesthesia, General
Autonomic Nervous System
Baroreflex
Blood Pressure
Carbon
Carbon Dioxide
Electrocardiography
Female
Gynecologic Surgical Procedures
Heart Rate
Hemodynamics
Humans
Laparoscopy
Methyl Ethers
Pneumoperitoneum
Carbon
Carbon Dioxide
Methyl Ethers