Document Detail

Cardiovascular autonomic function in patients with hemodynamic instability at induction of capnoperitoneum: a case-control study.
MedLine Citation:
PMID:  15095083     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: This study hypothesized that patients in whom bradycardia and hypotension develop with induction of positive-pressure capnoperitoneum have an underlying autonomic cardiovascular dysfunction. METHODS: A case-control study was conducted to examine the baseline autonomic function of patients in whom bradycardia and hypotension develop with induction of positive-pressure capnoperitoneum. The control group consisted of patients who maintained normal cardiac rhythm and blood pressure during the same procedure. Two groups of tests were performed: bedside stress tests of cardiovascular autonomic function (response graded 1 (normal) to 4 (severely abnormal) and heart rate variability analysis (spectral and time domain components). RESULTS: The study evaluated 6 patients in the bradycardia group and 10 in the control group. The group in whom bradycardia had developed scored significantly worse on the bedside stress tests than the control group (for grades I to IV: chi2 = 6.5, p = 0.022; for trend: chi2 = 5.6, p = 0.018). In contrast, both groups had similar baseline autonomic tone, as measured by heart rate variability. CONCLUSIONS: Patients in whom bradycardia and hypotension develop with induction of positive-pressure capnoperitoneum have cardiovascular autonomic dysfunction, which is identifiable by bedside stress tests of autonomic function.
A Alijani; G B Hanna; M Band; A D Struthers; A Cuschieri
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Publication Detail:
Type:  Journal Article     Date:  2004-04-21
Journal Detail:
Title:  Surgical endoscopy     Volume:  18     ISSN:  1432-2218     ISO Abbreviation:  Surg Endosc     Publication Date:  2004 Jun 
Date Detail:
Created Date:  2004-05-31     Completed Date:  2004-10-25     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8806653     Medline TA:  Surg Endosc     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  915-8     Citation Subset:  IM    
Department of Surgery, Ninewells Hospital and Medical School, DD1 9SY, Dundee, Scotland, UK.
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MeSH Terms
Autonomic Nervous System / physiopathology*
Autonomic Nervous System Diseases / complications*,  diagnosis,  drug therapy
Blood Pressure* / drug effects,  physiology
Bradycardia / etiology,  physiopathology*,  prevention & control
Carbon Dioxide / administration & dosage,  adverse effects*
Cardiac Output, Low / etiology,  physiopathology*,  prevention & control
Case-Control Studies
Exercise Test*
Glycopyrrolate / therapeutic use
Hand Strength
Heart Rate* / drug effects,  physiology
Hypotension / etiology,  physiopathology*,  prevention & control
Intraoperative Complications / etiology,  physiopathology*,  prevention & control
Pneumoperitoneum, Artificial / adverse effects*
Point-of-Care Systems
Predictive Value of Tests
Valsalva Maneuver
Reg. No./Substance:
124-38-9/Carbon Dioxide; 596-51-0/Glycopyrrolate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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