Abstract

ROSASCO, Carlos  and  BIANCHI, Domingo A. Monitoreo de las variaciones hemodinámicas en la colecistectomía laparoscópica . Anest Analg Reanim [online]. 2001, vol.17, n.1, pp.30-36. ISSN 1688-1273.

Laparoscopic cholecistecomy has been a great step towards a quick recovery of patients with a much better cost benefit. This technique that has been considered totally inocuous for the patient, has shown its drawbacks and its use is not free of dangers and possible complications. In our experience and in the literature reviewed we have seen important changes in hemodynamic and ventilatory parameters. Twelve patients ASA 1 and 2 with ages going from 27 years up to 82 years were analyzed. For the ventilator parameters a Datex AS3 was used and for the hemodynamic an esophageal Doppler monitor (EDM Deltex monitor) measuring the aortic flow. The hemodynamic parameters used were: corrected time flow, cardiac contractility through the aortic flow velocity, systolic volume, cardiac output, cardiac index and peripheral resistances. As a result of our measurements it was found that at the moment of the pneumoperitoneum was installed there was an important increase in the peripheral resistances with a lowering of the cardiac output and cardiac index with a diminished myocardial contractility in all the patients. Some therapeutic alternatives are suggested to improve these situation and we also establish the limitations of laparoscopic surgery.

Keywords : aparoscopic cholecistectomy; hemodinamic variations.

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