Physiologic Responses to Infrarenal Aortic Cross-Clamping during Laparoscopic or Conventional Vascular Surgery in Experimental Animal Model: Comparative Study.
Anesthesiol Res Pract 2008;
2008:581948. [PMID:
21197458 PMCID:
PMC3003954 DOI:
10.1155/2008/581948]
[Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2007] [Revised: 10/26/2007] [Accepted: 02/26/2008] [Indexed: 12/03/2022] Open
Abstract
The aim of this study was to compare the hemodynamic and ventilatory effects of prolonged infrarenal aortic cross-clamping in pigs undergoing either laparotomy or laparoscopy.
18 pigs were used for this study.
Infrarenal aortic crossclamping was performed for 60 minutes in groups
I (laparotomy, n = 6) and II (laparoscopy, n = 6). Group III (laparoscopy, n = 6) underwent a 120-minute long pneumoperitoneum in absence of aortic clamping (sham group).
Ventilatory and hemodynamic parameters and renal function were serially determined in all groups.
A significant decrease in pH and significant increase in PaCO2 were observed in group II, whereas no changes in these parameters were seen in group I and III. All variables returned to values similar to baseline in groups I and II 60 minutes after declamping. A significant increase in renal resistive index was evidenced during laparoscopy, with significantly higher values seen in Group II.
Thus a synergic effect of pneumoperitoneum and aortic cross-clamping was seen in this study. These two factors together cause decreased renal perfusion and acidosis, thus negatively affecting the patient's general state during this type of surgery.
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