Study of effect of pneumoperitoneum on hemodynamic parameters and cardiac function in patients undergoing laparoscopic cholecystectomy with and without cardiac disease

Abstract

Background: Gold standard surgical treatment for gallstone disease is Laparoscopic cholecystectomy. Over the years surgical skills have been improved and also there is better understanding of pneumoperitoneum3 Pneumoperitoneum stimulate a neuro-hormonal stress response which lead to increases heart rate, mean arterial blood pressure and systemic vascular resistance. Present study was designed to study the effect of pneumoperitoneum on hemodynamic parameters and cardiac function in patients undergoing laparoscopic cholecystectomy with and without cardiac disease. Material and Methods: Present study was prospective, comparative study, conducted in department of anaesthesiology. Study group was patients 18-65 years age, with echocardiographic findings consistent with presence of moderate to severe left ventricular systolic dysfunction, planned for laparoscopic cholecystectomy, Consented for participation, while control group was patients 18-65 years age, with normal echocardiographic finding, planned for laparoscopic cholecystectomy, Consented for participation. Results: Total 30 patients were enrolled in this prospective trial; 15 in each group. (Study and control group). The mean age of patients are 55.6 years and 36.6 years in study and control group, respectively and difference was statistically significant. Sex distribution: In control group, male: female distribution is 1:1.2; while in the study group, male: female distribution is 1:4, and difference was statistically significant. On intragroup statistical analysis, in the control group a statistically significant fall in HR is noticed at T2 and T4 from T1. Conclusion: Present study showed that laparoscopic cholecystectomy may be safely done in cardiac patients with moderate to severe left ventricular systolic dysfunction patients under the supervision of an experienced consultant anaesthesiologist.