Hemodynamic Changes during the Use of Different General Anesthetic Methods in Laparoscopic Gynecologic Surgery

Lee, Young Jae; Lee, Jung Un

Abstract

BACKGROUND: The purpose of our study is to evaluate the hemodynamic changes during the use of different general anesthetic methods in laparoscopic gynecologic surgery.
METHODS
45 women undergoing laparoscopic gynecologic surgery were randomly divided into 3 groups. The first group, called group P, used propofol for general anesthesia. The second group, called group D, used desflurane and the third group, called group S, used sevoflurane. The hemodynamic parameters HR (heart rate), MBP (mean blood pressure), CO (cardiac output), SV (stroke volume), CI (cardiac output), and SVR (systemic vascular resistance) were obtained 7 times by using a partial CO2 rebreathing method and an automated blood pressure device.
RESULTS
In the group D and group P, HR decreased significantly reaching the head-down position and CO2 insufflation. In the all groups, the MBP increased significantly after reaching the head-down position and CO2 insufflation. There were no significant differences among the groups in this test. In the all groups, CO, SV and CI decreased significantly after reaching the head-down position and CO2 insufflation, followed by a slight recovery to near-normal values or higher than normal after CO2 deflation, with the exception of group P. SVR increased significantly after reaching the head-down position and CO2 insufflation, followed by a slight recovery to near-normal values or higher than normal after CO2 deflation.
CONCLUSIONS
Laparoscopic gynecologic surgery with CO2 insufflation induces significant hemodynamic changes including increases of MBP, SVR and reduction of HR, CO, SV, CI (P < 0.05). These changes are especially significant in group P, used propofol except MBP (P < 0.05). But these changes of group P were all within normal limits.