Document Detail


Effects of epidural-and-general anesthesia combined versus general anesthesia alone on femoral venous flow during laparoscopic cholecystectomy.
MedLine Citation:
PMID:  20218940     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVE: The pneumoperitoneum has been shown to decrease femoral blood flow, resulting in venous stasis. We analyzed the effects of the pneumoperitoneum and epidural analgesia on femoral vein diameter and the peak flow rate of femoral vein during laparoscopic cholecystectomy. PATIENTS AND METHODS: Forty patients were randomly allocated to receive either combined epidural analgesia (EA) and general anesthesia (GA) (group EA/GA) or GA alone (group GA). Laparoscopic cholecystectomy was the standard operation for the selected patients. Then, 10 mL of 1% lidocaine in group EA/GA or physiologic serum in group GA was injected via epidural catheter. Peak flow rates (PFRs) of femoral vein cross-sectional areas (CSAs) were measured from the right femoral vein at three different times: after induction of anesthesia, during the pneumoperitoneum, and after abdominal deflation, but prior to reversal of anesthesia. RESULTS: The two groups were similar in age, sex, body mass index, and duration of operation. The CSA slightly increased after the induction of anesthesia, compared with the previous measurements, although there was no statistical significance between them for both groups (P > 0.05). The PFR decreased, whereas the CSA increased during the pneumoperitoneum in each group. The PFR values after basal measurements were significantly higher in the EA/GA than in the GA group (P < 0.05). Group EA/GA had significantly lower heart-rate and blood-pressure levels during surgery than those in group GA (P < 0.05). CONCLUSIONS: Abdominal insufflation during laparoscopic cholecystectomy results in dilation and decreased flow in the common femoral vein. Epidural analgesia added to the GA partially compensated for the reduction in femoral PFR.
Authors:
Nimet Senoglu; Mehmet F Yuzbasioglu; Hafize Oksuz; Huseyin Yildiz; Zafer Dogan; Ertan Bulbuloglu; Mustafa Goksu; Gokce Gisi
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of laparoendoscopic & advanced surgical techniques. Part A     Volume:  20     ISSN:  1557-9034     ISO Abbreviation:  J Laparoendosc Adv Surg Tech A     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-08     Completed Date:  2010-08-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9706293     Medline TA:  J Laparoendosc Adv Surg Tech A     Country:  United States    
Other Details:
Languages:  eng     Pagination:  219-23     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology and Reanimation, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey. nimetsenoglu@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anesthesia, Epidural / methods*
Anesthesia, General / methods*
Cholecystectomy, Laparoscopic / methods*
Female
Femoral Vein / physiology*
Hemodynamics / physiology
Humans
Male
Middle Aged
Regional Blood Flow
Vasodilation / physiology

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


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