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Korean J Anesthesiol > Volume 55(6); 2008 > Article
Korean Journal of Anesthesiology 2008;55(6):662-665.
DOI: https://doi.org/10.4097/kjae.2008.55.6.662   
The effect of carbon dioxide pneumoperitoneum on baroreflex sensitivity.
Seunghyun Chung, Hun Cho, Kyoung Ok Kim, Younsuk Lee, Jun Gwon Choi, Junyong In, Yun Suk Choe
1Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang, Korea. cho126@duih.org
2Department of Anesthesiology and Pain Medicine, Jeju National University College of Medicine, Jeju, Korea.
Abstract
BACKGROUND
To determine if positive pressure pneumoperitoneum has adverse effects on autonomic nervous system function, we examined baroreflex sensitivity (BRS) during carbon dioxide pneumoperitoneum in patients undergoing laparoscopic surgery.
METHODS
Twenty adult patients scheduled for laparoscopic gynecologic surgery were selected for the study. After general anesthesia was induced with sevoflurane, continuous electrocardiography and blood pressure were monitored. Spontaneous BRS was achieved using sequence method immediately before, and 5 minutes after, pneumoperitoneum. Heart rate variability (HRV) was also determined.
RESULTS
After pneumoperitoneum, BRS decreased from 12.9 +/- 1.8 ms/mmHg to 8.1 +/- 1.1 ms/mmHg (P < 0.05), and the power of the high frequency band decreased from 237.8 ms2/Hz to 49.6 ms2/Hz (P < 0.05).
CONCLUSIONS
Compared to recordings obtained before pneumoperitoneum, BRS was decreased during pneumoperitoneum. This may predispose patients undergoing laparoscopic surgery to hemodynamic instability in addition to pneumoperitoneum itself.
Key Words: autonomic nervous system; baroreflex sensitivity; carbon dioxide; laparoscopy; pneumoperitoneum


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