INCIDENTS DURING LAPAROSCOPY - HEMODYNAMIC DESTABILISATION - COINCIDENCE OR FACT?
Journal
Macedonian Journal of Anesthesia
Date Issued
2017-04
Author(s)
Demjanski V.
Osmani B.
Abstract
In the recent years, laparoscopic surgery has gained popularity in everyday surgical
practice. The effect of the artificial pneumoperitoneum with carbon dioxide (as standard gas for
insufflations during laparoscopy) on the hemodynamic and respiratory stability, has been widely
studied and known. On the other hand, many studies suggest that different gasses can be used for
pneumoperitoneum, even though their effect on cardiovascular system is not well established.
Controversial data from case reports, where accidentally different gasses were insufflated, open
new debate for patient stability and safety. We present a case of patient scheduled for elective
laparoscopic cholecystectomy where accidental intraabdominal insufflations of oxygen 100%
lead to marked hemodynamic destabilization. Our case, endured with scientific facts, give us
the right to suspect that when oxygen (O2) is insufflated with same pressure and flow as CO2
could correlate with hypotension and bradycardia more quickly than carbon dioxide. This leads
to a question”can anesthesiology intraoperative parameters serve as an important indicator for
preventing any serious complication during pneumoperitoneum?”. Another opened question is
“Should we always blindly believe in the declarations of the facilities and agents that we are
working with?”.
practice. The effect of the artificial pneumoperitoneum with carbon dioxide (as standard gas for
insufflations during laparoscopy) on the hemodynamic and respiratory stability, has been widely
studied and known. On the other hand, many studies suggest that different gasses can be used for
pneumoperitoneum, even though their effect on cardiovascular system is not well established.
Controversial data from case reports, where accidentally different gasses were insufflated, open
new debate for patient stability and safety. We present a case of patient scheduled for elective
laparoscopic cholecystectomy where accidental intraabdominal insufflations of oxygen 100%
lead to marked hemodynamic destabilization. Our case, endured with scientific facts, give us
the right to suspect that when oxygen (O2) is insufflated with same pressure and flow as CO2
could correlate with hypotension and bradycardia more quickly than carbon dioxide. This leads
to a question”can anesthesiology intraoperative parameters serve as an important indicator for
preventing any serious complication during pneumoperitoneum?”. Another opened question is
“Should we always blindly believe in the declarations of the facilities and agents that we are
working with?”.
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