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Title: Transcranial Doppler monitoring during laparoscopic anterior lumbar interbody fusion
Author: Colomina Soler, M. J. (María José)
Godet, Carmen
Pellisé, Ferran
Bagó, Joan
Villanueva, Carlos
Keywords: Laparoscòpia
Circulació sanguínia
Pressió sanguínia
Anestèsia per inhalació
Ecografia Doppler
Cirurgia laparoscòpica
Circulation of the blood
Blood pressure
Inhalation anesthesia
Doppler ultrasonography
Laparoscopic surgery
Issue Date: Dec-2003
Publisher: Lippincott, Williams & Wilkins. Wolters Kluwer Health
Abstract: We studied the consequences on cerebral hemodynamics of lengthy laparoscopic procedures requiring pneumoperitoneum and head-down positioning. From October 1995 to April 1999, 17 ASA status I or II patients (16 women and 1 man; mean age, 38 yr) were treated with laparoscopic anterior lumbar fusion. Besides standard perioperative monitoring for laparoscopic surgery, the mean blood-flow velocity of both middle cerebral arteries and the pulsatility index were determined by transcranial Doppler ultrasound. Adequate acoustic windows were encountered in 11 of the 17 patients, and the remaining 6 were excluded from the analysis. PaCO(2) and end-tidal CO(2) were maintained within normal limits (<40 mm Hg); ventilation was optimized in all cases. There was a significant increase (P < 0.05) in heart rate and central venous pressure with the change from supine to head-down position in all patients. Transcranial Doppler results for mean middle cerebral artery blood-flow velocity and pulsatility index showed no significant variations at any of the four time points studied during the procedure. There were no technique-related complications, except for moderate postoperative headache in eight patients that resolved with rest and oxygen therapy. We conclude that lengthy laparoscopic procedures in the head-down position performed in otherwise healthy patients do not significantly affect intracranial circulation.
Note: Versió postprint del document publicat a:
It is part of: Anesthesia and Analgesia, 2003, vol. 97, num. 6, p. 1675-1679
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ISSN: 0003-2999
Appears in Collections:Articles publicats en revistes (Ciències Clíniques)

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