J Korean Acad Nurs.  2010 Jun;40(3):433-441. 10.4040/jkan.2010.40.3.433.

The Effects of Pneumoperitoneum on Heart Rate, Mean Arterial Blood Pressure and Cardiac Output of Hypertensive Patients during Laparoscopic Colectomy

• Kim EJ
• Yoon H

• KMID: 987590
• DOI: http://doi.org/10.4040/jkan.2010.40.3.433

Abstract

PURPOSE
This study was performed to identify effects of pneumoperitoneum on hemodynamic changes of hypertensive patients undergoing laparoscopic colectomy under general anesthesia.
METHODS
Data collection was done from January 2 to June 10, 2008. Seventy-six patients, including 38 hypertensive patients, who had taken antihypertensive drugs more than 1 month and 38 normotensive patients undergoing laparoscopic colectomy were enrolled in this study. The hemodynamic parameters were heart rate (HR), mean arterial pressure (MAP) and cardiac output (CO) which were measured 7 times from before induction of anesthesia to 5 min after deflation of the pneumoperitoneum. Collected data were analyzed using Repeated Measures ANOVA and Bonferroni comparison method.
RESULTS
HR in the hypertensive group was significantly decreased at deflation of the pneumoperitoneum and 5 min after deflation of the pneumoperitoneum (p=.012). MAP in the hypertensive group was not different from the normotensive group (p=.756). CO in hypertensive group was significantly lower than normotensive group (p<.001) from immediately after pneumoperitoneum to 5 min after deflation of the pneumoperitoneum.
CONCLUSION
The results indicate that pneumoperitoneum during laparoscopic surgery does not lead to clinically negative hemodynamic changes in heart rate, mean arterial pressure or cardiac output of hypertensive patients, who have taken antihypertensive drugs for more than 1 month.

Keyword

Pneumoperitoneum; Hypertension; Heart rate; Blood pressure; Cardiac output

MeSH Terms

Aged
Anesthesia/methods
Antihypertensive Agents/therapeutic use
Blood Pressure/*physiology
Cardiac Output/*physiology
Colectomy
Colonic Neoplasms/surgery
Female
Heart Rate/*physiology
Humans
Hypertension/drug therapy/*physiopathology
Laparoscopy
Male
Middle Aged
*Pneumoperitoneum, Artificial

Figure

• 

  Figure 1 Heart rate between hypertensive and normotensive group (N=76). ***p<.001; †comparison between before induction and each time; ‡comparison between hypertensive and normotensive group; G*T=Group*Time. Time 1=before induction; Time 2=15 min after induction; Time 3=right after pneumoperitoneum; Time 4=10 min after pneumoperitoneum; Time 5=20 min after pneumoperitoneum; Time 6=right after deflation; Time 7=5 min after deflation; Score=Mean±SD.

• 

  Figure 2 Mean arterial pressure between hypertensive and normotensive group (N=76). **p<.01; ***p<.001; †comparison between before induction and each time; G*T=Group*Time. Time 1=before induction; Time 2=15 min after induction; Time 3= right after pneumoperitoneum; Time 4=10 min after pneumoperitoneum; Time 5=20 min after pneumoperitoneum; Time 6=right after deflation; Time 7=5 min after deflation; Score=Mean±SD.

• 

  Figure 3 Cardiac output between hypertensive and normotensive group (N=76). *p<.05; ***p<.001; †comparison between before induction and each time; ‡comparison between hypertensive and normotensive group; G*T=Group*Time. Time 1=right after induction; Time 2=15 min after induction; Time 3=right after pneumoperitoneum; Time 4=10 min after pneumoperitoneum; Time 5=20 min after pneumoperitoneum; Time 6=right after deflation; Time 7=5 min after deflation; Score=Mean±SD.

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