Document Detail


Stress responses during laparoscopy with CO2 insufflation and with mechanical elevation of the abdominal wall.
MedLine Citation:
PMID:  10924631     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY OBJECTIVE: To compare the intensity of stress responses caused by laparoscopy combined with CO2 insufflation (CI) with those caused by mechanical elevation of the abdominal wall (MEA). DESIGN: Prospective study (Canadian Task Force classification I). SETTING: Tertiary care university hospital. PATIENTS: Thirty-one women. Intervention. Laparoscopy, 16 with CI and 15 with MEA. MEASUREMENTS AND MAIN RESULTS: Circulating levels of norepinephrine, epinephrine, cortisol, and interleukin (IL)-6 were compared in the two groups. Arterial partial pressure of CO2 (PaCO2) did not increase during laparoscopy by either method. Plasma norepinephrine and epinephrine levels increased after extubation in the MEA group but not in the CI group. Circulating cortisol levels in both groups increased during laparoscopy; mean intraoperative levels were higher in the CI group. Serum IL-6 levels increased after extubation in the MEA but not the CI group. Mean heart rate increased during laparoscopy in both groups, whereas blood pressure increased only in the CI group. More patients in the MEA group required postoperative analgesia. CONCLUSION: Laparoscopy with MEA caused more pronounced adrenosympathetic and cytokine responses than that with CI when PaCO2 was maintained within the range of normocapnia.
Authors:
B Ishizuka; Y Kuribayashi; Y Kobayashi; N Hamada; Y Abe; A Amemiya; T Aoki; T Satoh
Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The Journal of the American Association of Gynecologic Laparoscopists     Volume:  7     ISSN:  1074-3804     ISO Abbreviation:  J Am Assoc Gynecol Laparosc     Publication Date:  2000 Aug 
Date Detail:
Created Date:  2000-10-19     Completed Date:  2000-10-19     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  9417443     Medline TA:  J Am Assoc Gynecol Laparosc     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  363-71     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae, Kawasaki, Kanagawa, Japan.
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MeSH Terms
Descriptor/Qualifier:
Carbon Dioxide
Epinephrine / blood*
Female
Humans
Hydrocortisone / blood*
Insufflation*
Interleukin-6 / blood*
Laparoscopy*
Norepinephrine / blood*
Prospective Studies
Stress, Physiological / blood*
Chemical
Reg. No./Substance:
0/Interleukin-6; 124-38-9/Carbon Dioxide; 50-23-7/Hydrocortisone; 51-41-2/Norepinephrine; 51-43-4/Epinephrine

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


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