Document Detail


Laparoscopic surgery during pregnancy.
MedLine Citation:
PMID:  16735807     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: In the past decade, laparoscopic procedures have become increasingly popular owing to decreased morbidity and convalescence compared with open procedures. The purpose of this review is to evaluate recent literature on laparoscopic surgery in pregnancy and make recommendations for anesthesia based on understanding of physiology of carbon dioxide pneumoperitoneum. RECENT FINDINGS: Increasing numbers of successful cases of laparoscopic surgery are being reported. For reasons unknown, the results obtained in sheep studies do not match the observations in humans. Maternal respiratory acidosis, a common finding in sheep studies during CO2 pneumoperitoneum has not been observed in pregnant women undergoing laparoscopic surgery. A recent finding of persisting fetal sheep hypoxia beyond the duration of CO2 pneumoperitoneum calls for further investigation to determine if this finding is limited to sheep akin to sheep maternal respiratory acidosis. SUMMARY: Present evidence suggests laparoscopic surgery in pregnancy is a safe option. Left uterine displacement, maintaining end-tidal carbon dioxide between 32-34 mmHg and maternal blood pressures within 20% of baseline, and limiting abdominal insufflation pressure of carbon dioxide to 12-15 mmHg are essential hallmarks of anesthesia procedure. Although no apparent long time consequences have been reported, further studies are necessary to confirm the validity of sheep fetal hypoxia studies.
Authors:
Nollag O'Rourke; Bhavani-Shankar Kodali
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in anaesthesiology     Volume:  19     ISSN:  0952-7907     ISO Abbreviation:  Curr Opin Anaesthesiol     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-05-31     Completed Date:  2006-09-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8813436     Medline TA:  Curr Opin Anaesthesiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  254-9     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
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MeSH Terms
Descriptor/Qualifier:
Acidosis, Respiratory / complications
Anesthesia / adverse effects*
Animals
Carbon Dioxide / administration & dosage,  adverse effects
Female
Humans
Laparoscopy / adverse effects*
Pneumoperitoneum / complications
Pregnancy
Pregnancy Complications / etiology
Sheep
Chemical
Reg. No./Substance:
124-38-9/Carbon Dioxide

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


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