Document Detail


Right vs left side thoracoscopic sympathectomy: effects of CO2 insufflation on haemodynamics.
MedLine Citation:
PMID:  11695797     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND AIMS: Currently, few reports of the haemodynamic impact of intrapleural CO2 insufflation in the clinical setting are available. Therefore, we conducted the present study to compare the haemodynamic changes between right and left side thoracoscopic sympathectomy (TS) for treatment of palmar hyperhidrosis (PH) under general anaesthesia. MATERIALS AND METHODS: 20 adult patients (17 males) undergoing TS were randomly allocated to two groups (each 10); group A, right side and group B, left side TS procedures were performed under general anaesthesia with single-lumen endotracheal tube. Besides the routine monitoring of vital signs, non-invasive cardiac output monitor (NICO) was used to record the stroke volume (SV), cardiac output (CO) and cardiac index (CI). Intrapleural CO2 insufflation was used. Anaesthesia was maintained with 1 MAC sevoflurane in 50% nitrous oxide in oxygen with incremental doses of sufentanil and atracurium when required. Haemodynamic parameters were obtained every 3 min then averaged over the time of surgery at phases; I) after tracheal intubation, II) after CO2 insufflation and III) after CO2 deflation. RESULTS: The CO, CI and SV showed decreased trend in both groups during phase II compared to phase I with significant differences (P < 0.05). Comparing the CO and CI variables revealed lower values in group A compared to group B but with non-significant differences (P > 0.05). While the SV variable showed significant low value in group A compared to group B (P < 0.05). CONCLUSIONS: Compared to left side TS, direct compression by CO2 against the venae cava and right atrium and ventricle during right side TS caused reduction of the venous return and hence low CO, CI and SV.
Authors:
A A El-Dawlatly; A Al-Dohayan; A Samarkandi; F Algahdam; A Atef
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Annales chirurgiae et gynaecologiae     Volume:  90     ISSN:  0355-9521     ISO Abbreviation:  Ann Chir Gynaecol     Publication Date:  2001  
Date Detail:
Created Date:  2001-11-06     Completed Date:  2002-03-28     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7609767     Medline TA:  Ann Chir Gynaecol     Country:  Finland    
Other Details:
Languages:  eng     Pagination:  206-8     Citation Subset:  IM    
Affiliation:
Department of Anaesthesia, College of Medicine, King Saud University, Riyadh, Saudia Arabia. dawlatly@ksu.edu.sa
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MeSH Terms
Descriptor/Qualifier:
Adult
Anesthesia, General / methods
Carbon Dioxide
Cardiac Output
Functional Laterality
Hand / innervation
Hemodynamics / physiology*
Humans
Hyperhidrosis / surgery
Insufflation*
Male
Stroke Volume
Sympathectomy / methods*
Thoracoscopy / methods*
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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