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Intermittent pneumatic sequential compression of the lower extremities restores the cerebral oxygen saturation during laparoscopic cholecystectomy

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Abstract

Background

Pneumoperitoneum causes intracranial pressure elevation and blood stasis at lower extremities. This study investigates cerebral oxygen saturation changes during laparoscopy and the effects of intermittent sequential compression (ISC) of the lower extremities in patients during elective laparoscopic cholecystectomy.

Patients and method

Sixty patients were randomly divided into two groups according to the application of ISC to the lower extremities. Group I served as control group whereas ISC was applied to group II. Cerebral oxygen saturation, peripheral blood oxygen saturation, heart rate, mean blood pressure, and associated changes have been recorded during the operation.

Results

Peripheral blood oxygen saturation and mean blood pressure values did not change significantly after pneumoperitoneum. Cerebral oxygen saturation levels of the group II patients were higher in than the group I patients and the difference between the groups was statistically significant (p = 0.0001). The difference became more prominent following the 35th minute of the operation. Mean heart rate of the patients in group II was lower than the patients in group I and the difference was also statistically significant (p = 0.0001).

Conclusion

In this study, it was found that the decrease in cerebral oxygen saturation was recovered with ISC application. This simple and reliable technique helps to restore cerebral oxygen saturation levels while increasing blood return from the lower extremities.

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References

  1. Alishahi S, Francis N, Crofts S, Duncan L, Bickel A, Cuschieri A (2001) Central and peripheral adverse hemodynamic changes during laparoscopic surgery and their reversal with a novel intermittent sequential pneumatic compression device. Ann Surg 233:176–182

    Article  PubMed  CAS  Google Scholar 

  2. Bickel A, Yahalom M, Roguin N, Ivry S, Breslava J, Frankel R, Eitan A (2004) Improving the adverse changes in cardiac autonomic nervous control during laparoscopic surgery, using an intermittent sequential pneumatic compression device. Am J Surg 187:124–127

    Article  PubMed  Google Scholar 

  3. Bloomfield GL, Ridings PC, Blocher CR, Marmarou A, Sugerman HJ (1997) A proposed relationship between increased intraabdominal, intrathorasic, and intracranial pressure. Crit Care Med 25:496–503

    Article  PubMed  CAS  Google Scholar 

  4. Bloomfield GL, Ridings PC, Blocher CR, Marmarou A, Sugerman HJ (1996) Effects of increased intraabdominal pressure upon intracranial and cerebral perfusion pressure before and after volume expansion. J Trauma 40:936–941

    PubMed  CAS  Google Scholar 

  5. Brown FK (1956) Cardiovascular effects of acutely raised intracranial pressure. Am J Physiol 185:510–514

    PubMed  CAS  Google Scholar 

  6. Christen Y, Reymond MA, Vogel JJ, Klopfenstein CE, Morel P, Bounameaux H (1995) Hemodynamic effects of intermittent pneumatic compression of the lower limbs during laparoscopic cholecystectomy. Am J Surg 170:395–398

    Article  PubMed  CAS  Google Scholar 

  7. Cooke SJ, Paterson-Brown S (2001) Association between laparoscopic abdominal surgery and postoperative symptoms of raised intracranial pressure. Surg Endosc 15:723–725

    Article  PubMed  CAS  Google Scholar 

  8. Cullen LK, Steffey EP, Bailey CS, Kortz G, Da Silva Curiel J, Belhorn RW, Woliner MJ, Elliot AR, Jarvis KA (1990) Effect of high PaCO2 and time on cerebrospinal fluid and intraocular pressure in halothane anesthetized horses. Am J Vet Res 51:300–304

    PubMed  CAS  Google Scholar 

  9. Gennarelli TA, Champion HR, Sacco WJ, Copes WS, Alves WM (1989) Mortality of patients with head injury and extracranial injury treated in trauma centers. J Trauma 29:1193–1201

    PubMed  CAS  Google Scholar 

  10. Guyton AC (1991) Nervous regulation of the circulation and rapid control of arterial pressure. In Guyton AC (ed.) Phisiology, WB Saunders, Philadelphia, pp 202–203

    Google Scholar 

  11. Halverson A, Buchanan R, Jacobs L, Shayani V, Hunt T, Riedel C, Sackier J (1998) Evaluation of mechanism of increased intracranial pressure with insufflation. Surg Endosc 12:266–269

    Article  PubMed  CAS  Google Scholar 

  12. Hanel F, Blobner M, Bogdanski R, Werner C (2001) Effects of carbon dioxide pneumoperitoneum on cerebral hemodynamics in pigs. J Neurosurg Anesth 13:222–226

    Article  CAS  Google Scholar 

  13. Hargreaves DM (1990) Hypercapnia and raised cerebrospinal fluid pressure. Anesthesia 45:7–12

    Article  Google Scholar 

  14. Hariri RJ, Firlick AD, Shepard SR, Cohen DS, Barie PS, Emery JM, Ghajar JB (1993) Traumatic injury, hemorrhagic shock and fluid resuscitation, effects on intracranial pressure and brain compliance. J Neurosurg 79:421–427

    Article  PubMed  CAS  Google Scholar 

  15. Hoff JT, Reis DJ (1970) Localization of regions mediating the Cushing response in CNS of cat. Arch Neurol 23:228–240

    PubMed  CAS  Google Scholar 

  16. Ido K, Suzuki T, Kimura K, Taniguchi Y, Kawamoto C, Isoda N, Nagamine N, Ioka T, Kumagai M, Hirayama Y (1995) Lower extremity venous stasis during laparoscopic cholecystectomy as assessed using Doppler ultrasound. Surg Endosc 9:310–313

    Article  PubMed  CAS  Google Scholar 

  17. Irgau I, Koyfman Y, Tikelis JI (1995) Elective intraoperative intracranial pressure monitoring during laparoscopic cholecystectomy. Arch Surg 130:1011–1013

    PubMed  CAS  Google Scholar 

  18. Jorgensen JO, Lalak NJ, North L, Hanel K, Hunt DR, Morris DL (1994) Venous stasis during laparoscopic cholecystectomy. Surg Laparosc Endosc 4:128–133

    PubMed  CAS  Google Scholar 

  19. Josephs LG, Este McDonald JR, Birkett DH, Hirsch EF (1993) Diagnostic laparoscopy increases intracranial pressure. J Trauma 36:815–819

    Article  Google Scholar 

  20. Josephs LG, Este-McDonald JR, Birkett DH, Hirsch EF (1994) Diagnostic laparoscopy increases intracranial pressure. J Trauma 36:815–818

    PubMed  CAS  Google Scholar 

  21. Le Roith D, Bark H, Nyska M, Glick SM (1982) The effect of abdominal pressure on plasma antidiuretic hormone levels in the dog. J Surg Res 32:65–69

    Article  PubMed  CAS  Google Scholar 

  22. Milhorat TH (1975) The third circulation revisited. J Neurosurg 42:628–645

    PubMed  CAS  Google Scholar 

  23. Millard JA, Hill BB, Cook PS, Fenoglio ME, Stahlgren LH (1993) Intermittent sequential pneumatic compression in prevention of venous stasis associated with pneumoperitoneum during laparoscopic cholecystectomy. Arch Surg 128:914–918

    PubMed  CAS  Google Scholar 

  24. Mobbs RJ, Yang MO (2002) The dangers of diagnostic laparoscopy in the head injured patient. J Clin Neurosci 9:592–593

    Article  PubMed  Google Scholar 

  25. Moncure M, Salem R, Moncure K, Testaiuti M, Marburger R, Ye X, Brathwaite C, Ross SE (1999) Central nervous system metabolic and physiologic effects of laparoscopy. Am Surg 65:168–172

    PubMed  CAS  Google Scholar 

  26. Reis DJ, Ruggiero DA, Morrison SF (1989) The CI area of the rostral ventrolateral medulla oblongata, a critical brainstem region for control of resting and reflex integration of arterial pressure. Am J Hypertens 2:363–374

    Google Scholar 

  27. Rosenthal RJ, Freedman RL, Kahn AM, Martz J, Thagayah S, Cohen D, Shi Q, Nussbaum M (1988) Reasons for Intracranial Hypertension and hemodynamic instability during acute elevations of intra-abdominal pressure: observations in a large animal model. J Gastrointest Surg 2:415–425

    Article  Google Scholar 

  28. Rosenthal RJ, Hiatt JR, Phillips EH, Hewitt W, Demetrioti AA, Grode M (1997) Intracranial Pressure. Effects of pneumoperitoneum in a large animal model. Surg Endosc 11:376–380

    Article  PubMed  CAS  Google Scholar 

  29. Schob OM, Allen DC, Benzel E, Curet MJ, Adams MS, Baldwin NG, Largiader F, Zucker KA (1996) A comparison of the pathophysiologic effects of carbon dioxide, nitrous oxide, and helium pneumoperitoneum on intracranial pressure. Am J Surg 172:248–253

    Article  PubMed  CAS  Google Scholar 

  30. Schwenk W, Bohm B, Fugener A, Muller JM (1998) Intermittent pneumatic sequential compression (ISC) of the lower extremities prevents venous stasis during laparoscopic cholecystectomy. A prospective randomized study. Surg Endosc 12:7–11

    CAS  Google Scholar 

  31. Schwenk W, Haase O, Junghans T (2002) Perspectives in sequential pneumatic compression of the lower extremities (SCD) for laparoscopic surgery. Acta Chir Belg 102:83–91

    PubMed  CAS  Google Scholar 

  32. Walder AD, Aitkenhead AR (1997) Role of vasopressin in the heamodynamic response to laparoscopic cholecystectomy. Br J Anaesth 78:264–266

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of General Surgery, Gazi University Medical School, Ankara, Turkey

    Osman Kurukahvecioglu, Mustafa Sare, Ahmet Karamercan, Ziya Anadol & Ekmel Tezel

  2. Department of Anesthesiology, Gazi University Medical School, Ankara, Turkey

    Berrin Gunaydin

  3. Gazi Üniversitesi Tıp Fakültesi, Genel Cerrahi Anabilim Dalı, 06510, Beşevler, Ankara, Turkey

    Mustafa Sare

Authors
  1. Osman Kurukahvecioglu
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  2. Mustafa Sare
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Correspondence to Mustafa Sare.

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Kurukahvecioglu, O., Sare, M., Karamercan, A. et al. Intermittent pneumatic sequential compression of the lower extremities restores the cerebral oxygen saturation during laparoscopic cholecystectomy. Surg Endosc 22, 907–911 (2008). https://doi.org/10.1007/s00464-007-9505-4

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  • DOI: https://doi.org/10.1007/s00464-007-9505-4

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