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Acta médica Grupo Ángeles
versión impresa ISSN 1870-7203
Resumen
SILVA SANCHEZ, Liliana; RODRIGUEZ ZAMORANO, Diana Leticia; ELIZALDE FLORES, Fernando y RENDON MACIAS, Mario Enrique. Correlation between direct medical intraabdominal measurements with the CO 2 insufflation pressure in laparoscopic surgery. Acta méd. Grupo Ángeles [online]. 2017, vol.15, n.3, pp.194-199. ISSN 1870-7203.
Introduction:
An intraabdominal pressure less than 14 mmHg is fundamental to avoid hemodynamic alterations during laparoscopic procedures. The monitoring by insufflation pressure (InfP) may not be the most reliable.
Objective:
To compare the InfP values with those measured directly in the abdominal cavity (IAP), and to establish their correlation with hemodynamic variations.
Material and methods:
During eight laparoscopic procedures, we obtained InfP and IAP measures simultaneously: at baseline and every five minutes until the suspension of the pneumoperitoneum. All procedures were under general anesthesia and deep and/or intense neuromuscular blockage. We analyzed the hemodynamic stability (heart rate, arterial pressure and peripheral oxygen saturation) with the InfP and IAP measures.
Results:
We analyzed 54 pair measures. The correlation between measures was 0.86 (p < 0.001, R2 = 0.74). Fifteen measures (27.8%) were equal; in 59.3% IAP > InfP, and in 14.1% IAP < InfP. The variations of IAP ≥ 14 mmHg were associated with arterial hypertension and tachycardia, while IAP ≤ 11 mmHg were associated with low diastolic arterial pressures and low heart rate (< 60).
Conclusions:
The monitoring of the intra-abdominal pressure with InfP may not be reliable, so we recommend a direct measurement.
Palabras llave : Intraabdominal pressure; pneumoperitoneum; correlation.