scholarly journals Anesthetic Management for Gynecological Laparoscopic Surgery: II. Comparison of Stress Responses Using Abdominal Wall Lift and Carbon Dioxide Insufflation Methods.

1997 ◽  
Vol 17 (4) ◽  
pp. 245-250 ◽  
Author(s):  
Yukihiko OGIHARA ◽  
Hidemi MATSUOKA ◽  
Hiroyuki UCHINO ◽  
Atsushi ISSHIKI ◽  
Keiichi ISAKA ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Laparoscopic Surgery ◽  
Abdominal Wall ◽  
Stress Responses ◽  
Anesthetic Management ◽  
Carbon Dioxide Insufflation

Acetazolamide Reduces Referred Postoperative Pain after Laparoscopic Surgery with Carbon Dioxide Insufflation

2003 ◽  
Vol 99 (4) ◽  
pp. 924-928 ◽  
Author(s):  
Harvey J. Woehlck ◽  
Mary Otterson ◽  
Hyun Yun ◽  
Lois A. Connolly ◽  
Daniel Eastwood ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Laparoscopic Surgery ◽  
Carbonic Anhydrase ◽  
Carbonic Acid ◽  
Referred Pain ◽  
Double Blind Study ◽  
Carbon Dioxide Insufflation ◽  
Double Blind ◽  
Pain Scores ◽  
Incisional Pain

Background Carbon dioxide is the preferred insufflating gas for laparoscopy because of greater safety in the event of intravenous embolism, but it causes abdominal and referred pain. Acidification of the peritoneum by carbonic acid may be the major cause of pain from carbon dioxide insufflation. Carbonic anhydrase is an enzyme that increases the rate of carbonic acid formation from carbon dioxide. Because acetazolamide inhibits carbonic anhydrase, the authors hypothesized that the pain caused by carbon dioxide insufflation may be decreased by the administration of acetazolamide. Methods A prospective, randomized, double-blind study of 38 patients undergoing laparoscopic surgery during general anesthesia was performed. Acetazolamide (5 mg/kg) or a saline placebo was administered intravenously during surgery. Pain was rated on a visual analog scale (0-10) at four times: when first awake, at discharge from the recovery room, when discharged from the hospital, and on the day after surgery. The site and quality of pain were recorded, as were medications and side effects. Results Initial referred pain scores were lower after acetazolamide (1.00 +/- 1.98; n = 18) than after placebo (3.40 +/- 3.48; n = 20; P = 0.014), and 78% of patients in the acetazolamide group had no referred pain; however, only 45% patients in the placebo group had no referred pain. Incisional pain scores were not statistically different, and referred pain scores were similar at later times. Conclusions Acetazolamide reduces referred but not incisional pain after laparoscopic surgical procedures. The duration of pain reduction is limited to the immediate postsurgical period.

Catecholamine Release caused by Carbon Dioxide Insufflation during Laparoscopic Surgery

1996 ◽  
pp. 1368-1371 ◽  
Author(s):  
Osamu Mikami ◽  
Shigenari Kawakita ◽  
Kumiko Fujise ◽  
Koh Shingu ◽  
Hakuo Takahashi ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Laparoscopic Surgery ◽  
Catecholamine Release ◽  
Carbon Dioxide Insufflation

Abdominal wall lift versus carbon dioxide insufflation for laparoscopic resection of ovarian tumors

1999 ◽  
Vol 11 (5) ◽  
pp. 406-412 ◽  
Author(s):  
Yukihiko Ogihara ◽  
Atsushi Isshiki ◽  
James D Kindscher ◽  
Hiroshi Goto
Keyword(s):  
Carbon Dioxide ◽  
Abdominal Wall ◽  
Laparoscopic Resection ◽  
Ovarian Tumors ◽  
Carbon Dioxide Insufflation

Anesthesia for Laparoscopic Surgery: Anesthetic Management and Complications

2022 ◽  
Author(s):  
Edward A. Bittner ◽  
Shiliang Alice Cao
Keyword(s):  
Carbon Dioxide ◽  
Laparoscopic Surgery ◽  
Subcutaneous Emphysema ◽  
Anesthetic Management ◽  
Multiple Organ ◽  
Port Placement ◽  
Carbon Dioxide Pneumoperitoneum ◽  
Carbon Dioxide Gas ◽  
Surgical Access ◽  
Organ Systems

Laparoscopic surgery results in physiologic changes that encompass multiple organ systems, with respiratory, cardiovascular and neurologic and splanchnic effects. Insufflation of the peritoneum results in reduced lung volumes, atelectasis, and endobronchial migration of the endotracheal tube. Pneumoperitoneum can result in changes to venous return, cardiac output and blood pressure. Hypercapnia due to carbon dioxide gas used in insufflation can reduce cerebral perfusion pressure. Complications during laparoscopic surgery often occur during port placement and creation of the pneumoperitoneum. Problems include injury to blood vessels during trocar entry, vascular injury in the pneumoperitoneum with limited surgical access, severe bradycardia and arrhythmias due to vagal stimulation from peritoneal stretching, subcutaneous emphysema, pneumothorax, gas embolism, and complications associated with steep Trendelenburg positioning. A thorough understanding of the physiologic changes associated with laparoscopic procedures and recognition of potential complications will facilitate in optimal patient care.  This review contains 4 figures, 1 table and 52 references Keywords: Laparoscopy; laparoscopic surgery; carbon dioxide; pneumoperitoneum; capnothorax; general anesthesia; subcutaneous emphysema; insufflation 

Catecholamine Release caused by Carbon Dioxide Insufflation during Laparoscopic Surgery

1996 ◽  
Vol 155 (4) ◽  
pp. 1368-1371 ◽  
Author(s):  
Osamu Mikami ◽  
Shigenari Kawakita ◽  
Kumiko Fujise ◽  
Koh Shingu ◽  
Hakuo Takahashi ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Laparoscopic Surgery ◽  
Catecholamine Release ◽  
Carbon Dioxide Insufflation
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