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Randomized trial of different insufflation pressures for laparoscopic cholecystectomy

Wallace, D.H., Serpell, M., Baxter, J.N., and O'Dwyer, P. (1997) Randomized trial of different insufflation pressures for laparoscopic cholecystectomy. British Journal of Surgery, 84 (4). pp. 455-458. ISSN 0007-1323 (doi:10.1046/j.1365-2168.1997.02628.x)

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Abstract

Background The factors affecting cardiorespiratory changes and postoperative pain after laparoscopic cholecystectomy are poorly understood. The aim of this study was to assess these changes in patients undergoing laparoscopic cholecystectomy at an insufflation pressure of 7.5 or 15 mmHg.

Methods Forty patients with similar preoperative characteristics were randomized, 20 to each group.

Results There were no significant differences in intraoperative heart rate or cardiac index, although the latter fell significantly soon after insufflation in both groups. The fall in cardiac index lasted longer (7 versus 2 min) and coincided with a slower rise in mean arterial pressure in those having 15 mmHg insufflation. Changes in peak airway pressure, end‐tidal carbon dioxide and arterial blood gases were similar. After operation the low‐pressure group had significantly less pain, better preservation of pulmonary function and were discharged home sooner (P = 0.015).

Conclusions Insufflation pressure significantly affects the haemodynamic changes and postoperative pain associated with laparoscopic cholecystectomy.

Item Type:Article
Status:Published
Refereed:Yes
Glasgow Author(s):O'Dwyer, Prof Patrick and Serpell, Dr Michael
Authors: Wallace, D.H., Serpell, M., Baxter, J.N., and O'Dwyer, P.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine
Journal Name:British Journal of Surgery
Journal Abbr.:Br J. Surg.
Publisher:John Wiley & Sons Ltd.
ISSN:0007-1323
ISSN (Online):1365-2168

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