الفهرس 
Laparoscopy and anesthesiaOnly 14 pages are availabe for public view
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Abstract
Background: Laparoscopic procedures have greatly improved over the last few years with advances in both anesthetic and surgical techniques. Aim of the Work: to compare the hemodynamic and pulmonary changes in a patient undergoing laparoscopic cholecystectomy using different preset intra-abdominal pressures due to carbon dioxide insufflation. Patients and Methods: The study was conducted on 70 adult patients of ASA physical status I and II, scheduled for laparoscopic cholecystectomy surgery. Their age ranged from 18-60 years, of both sexes. General anesthesia with endotracheal intubation and controlled ventilation was conducted in all patients. Patients were randomly divided into two equal groups. group I; patients with intra-abdominal pressure maintained at 10 mmHg during surgery. group II; patients with intra-abdominal pressure maintained at 15mmHg and above during surgery. selected hemodynamic and pulmonary parameters were measured throughout the surgery in certain time intervals in the two groups. Results: Low intra-abdominal pressure reduces the incidence of hemodynamic and ventilatory changes that might lead to minimal and transient organ dysfunction and decreases the chances of physiological changes to transform into complications. Conclusion: The use of a low intraabdominal pressure alleviates many of the adverse hemodynamic and ventilatory effects of insufflation and may be suited particularly to patients with poor cardiovascular and pulmonary reserve. We suggest that high risk patients with cardiac and respiratory diseases can be operated with lower morbidity and mortality rates by obtaining well cardio-pulmonary monitorization and avoiding unnecessary high intra-abdominal pressure.