Effect of pneumoperitoneum and/or body position on stroke volume variation in patients undergoing gynecological laparoscopy
10.3760/cma.j.cn131073.20231010.00414
- VernacularTitle:气腹或/和体位因素对腹腔镜手术患者每搏量变异度的影响
- Author:
Zhenhuan HOU
1
;
Qinglin ZHANG
Author Information
1. 北京市通州区妇幼保健院麻醉科，北京 101199
- Keywords:
Stroke volume;
Blood volume;
Monitoring, intraoperative;
Pneumoperitoneum, artificial;
Posture
- From:
Chinese Journal of Anesthesiology
2024;44(4):454-456
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effect of carbon dioxide pneumoperitoneum and/or body position on stroke volume variation in the patients undergoing gynecological laparoscopy.Methods:Twenty patients undergoing gynecological laparoscopy were included in the study. After routine induction of general anesthesia, all the patients were intubated and mechanically ventilated with a tidal volume of 8 ml/kg and a respiratory rate of 8-12 times/min. General anesthesia was maintained. Stroke volume (SV) and stroke volume variation (SVV) were monitored with the FloTrac/Vigileo system at supine position without pneumoperitoneum (T 1), 15° head-down tilt position without pneumoperitoneum (T 2), supine position with pneumoperitoneum pressure (IAP) of 12 mmHg (T 3), 15° head-down tilt position with IAP 12 mmHg (T 4), supine position with IAP of 15 mmHg (T 5) and 15° head-down tilt position with IAP of 15 mmHg (T 6). Results:There were no significant differences in SV and SVV between T 2 and T 1 ( P>0.05). SVV was significantly increased and SV decreased at T 3-6 than at T 1 and T 2 ( P<0.05). There was no significant difference in SV between T 5 and T 3 and between T 6 and T 4 ( P>0.05). SVV was significantly higher at T 5 than at T 3 and at T 6 than at T 4 ( P<0.05). Conclusions:Although body position has no significant impact on SVV, the carbon dioxide pneumoperitoneum has a greater influence, indicating that SVV is not suitable for assessing blood volume status during laparoscopic surgery.
