Abstract :
Background and Aims: During laparoscopic procedures, hemodynamic stability is of great concern. This
study was carried out to evaluate hemodynamic Changes with different intra- abdominal pressure (IAP) for
laparoscopic cholecystectomy using Advanced Cardiac Output (FloTrac) Monitoring.
Materials and Methods: In this Prospective, randomized and observational study, total 90 patients ASA
grade I, II scheduled for laparoscopic cholecystectomy were randomly allocated to three groups: Group
I :10-12mm hg, groupII-13-15mmhg, Group III- > 15mmhg. Central venous line and arterial cannula
was secured before induction and connected to FloTrac monitor. Heart rate (HR), Cardiac index (CI),
Systemic vascular resistance index (SVRI), Stroke volume variation (SVV), Oxygen saturation (SPO2)
were monitored at various interval. For Statistical analysis student t-test and ANOVA test were used.
Results: At all time intervals, HR of Group I was found to be lower than Group II and Group III except
at insufflation. CI (Cardiac Index) of Group I was also found to be lower than that of Group II and that of
Group III was lower than that of Group II at all time intervals. At all time periods values of SVRI, SVV of
Group I were found to be lower than that of Group II and Group III. SVRI, SVV of Group II were found to
be lower than that of Group III.
Conclusions: IAP value above 15mm Hg seems to affect the hemodynamics significantly. Study showed
that the IAP rise from 10-12 to 13-15 does not influence hemodynamics significantly, and could be adjudged
relatively safe.
Keyword :
Intra-abdominal pressure, Laparoscopic cholecystectomy, Hemodynamic paramaters, Cardiac index, Systemic vascular resistance index, Stroke volume variation flow-trac.