Effects of Laparoscopic Cholecystectomy on the Cardiopulmanary and Neuroendocrine System

Kim, Tai Soo; Lee, Jun Hak; Lee, Ki Nam; Moon, Jun Il; Lee, Young Hee; Shin, Sung Hye

Abstract

Laparoscopy is a useful procedure for the diagnostic and therapeutic purpose, but it may be associated with many complieations related to large amounts of CO2 insufflation into the peritoneal cavity. To investigste the influence of laparoscopy 15 ASA classification I, II sur- gical patients were selected. We measured the changes in mean arterial pressure(MAP), heart rate(HR), PaO2, PaCO2, end tidal CO2 tension(PETCO2) and stress hormones such as plsma epinephrine, norepinephrine and cortisol. Above parameters were messured 10 minutes after intubation(control value), immediately after CO2 insufflation, 30 minutes after CO2 insufflation and 20 minutes after CO deflation. The results were ss follows 1) Mean arterial pressure was increased at immediately after CO2 insufflation, 30 minutes after CO2 insufflation(p<0.01) and 20 minutes after CO2 deflation(p<0.05). Heart rate was not changed significsntly. 2) PaCO2 was decreased at 30 minutes after CO2 insufflation(p<0.05), but PaCO2 snd PaCO2 were increased at 30 minutes after CO2 insufflation and 20 minutes efter CO2 deflation (p <0.01). 3) The increase of plasma epinephrine at immediately after CO2 insufflation end 30 minutes after CO2 insufflation was not significant, but plasma norepinephrine was increased at immediately after CO2 insufflstion and 30 minutes after CO2 insufflation(p<0.01). Plasme cortisol was increased at immediately after CO2 insufflstion, 30 minutes after CO2 insufflation and 20 minutes after CO2 deflation(p<0.01). We concluded that laparoscopy with CO2 insufflation has some effects on cardiopulmonary and neuroendocrine system and it is recommended to monitor carefully blood pressure, heart rate and PETCO2 for preventing hypercarbia related complications.