Document Detail


Improving the adverse changes in cardiac autonomic nervous control during laparoscopic surgery, using an intermittent sequential pneumatic compression device.
MedLine Citation:
PMID:  14706602     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The creation of positive pressure pneumoperitoneum (PP) may lead to adverse cardiovascular effects during laparoscopic operations. It can also lead to increased sympathetic cardiac activity, that might have serious consequences. We hypothesized that by reversing the hemodynamic effects, the use of intermittent sequential pneumatic compression device (Lympha-press) on the lower extremities would lead to improved cardiac autonomic control. METHODS: This was a prospective cohort study, in which patients served as their own control. Fifteen patients without cardiorespiratory disease undergoing elective laparoscopic cholecystectomy were enrolled prospectively. The activity of the cardiac autonomic nervous system was evaluated by using spectral analysis of heart rate variability, with the Del Mar Avionics 363 (Irvine, California), based on the fast Fourier transformation. The Lympha-press was manipulated several minutes after induction of PP. In each frequency band we measured and compared the power values during anesthesia against those of PP, as well as those of PP against those recorded during activation of Lympha-press. RESULTS: Creation of PP caused increased sympathetic activity, as was manifested by increased power of the low frequency band. Manipulation of the Lympha-Press compression device caused increased parasympathetic activity, as was evident by significant increased power of the high frequency band in all patients. CONCLUSIONS: Using an intermittent sequential pneumatic compression device during laparoscopic cholecystectomy may improve cardiac autonomic control by enhancing protective parasympathetic activity. That may have clinical significance, especially in patients suffering from cardiac disease, by improving heart rate variability and elevating the threshold of the occurrence of ventricular arrhythmia.
Authors:
Amitai Bickel; Malka Yahalom; Nathan Roguin; Shimon Ivry; Jona Breslava; Roman Frankel; Arie Eitan
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of surgery     Volume:  187     ISSN:  0002-9610     ISO Abbreviation:  Am. J. Surg.     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2004-01-06     Completed Date:  2004-02-02     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370473     Medline TA:  Am J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  124-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Western Galilee Hospital, Nahariya, Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel. amitai@netvision.net.il
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Autonomic Nervous System / physiopathology*
Female
Heart / physiopathology*
Humans
Laparoscopy / adverse effects*
Male
Middle Aged
Pneumoperitoneum, Artificial* / instrumentation
Prospective Studies

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