Hemodynamic Changes During Laproscopic Cholecystectomy at Lumbini Medical College

Background: Laparoscopic cholecystectomy is preferred to open cholecystectomy for several reasons. Patients can be discharged home earlier. They have less pain in comparision to open cholecystectomy. Objectives: To investigate the pneumoperitoneum-induced haemodynamic and ventilatory changes in patients undergoing laproscopic cholycystectomy (LC). Methods: It was a prospective study of the age 15 years to 75 years of both sex (males n=80 and females n =320) were included in the study. The study was conducted in Lumbini Medical College Palpa over the two year period in Jan 2010 and Dec 2012. The variables recorded were: Mean arterial pressure (MAP), End- dal CO2, Peak and plateau airway pressures and heart rate. Data were collected immediately after induction of anesthesia at 5 min , after peritoneal insufflations and tilting the table into 30° head-up position at 10 min and finally at 10 min after exsufflation. Results: There was decrease in MAP after head up position but there was little change after pneumoperitoneum. More the weight more the increased in airway pressure was observed. The end tidal CO2 ramained increased after pneumoperitoneum. Conclusion: Peritoneal insufflation of CO2 to create the pneumoperitoneum and tilting the patient to the head-up position necessary for laparoscopy induces intraoperative ventilatory and hemodynamic changes that complicate anesthetic management of laparoscopy