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Korean Journal of Anesthesiology 2005;49(4):513-517.
DOI: https://doi.org/10.4097/kjae.2005.49.4.513   
Effects of a Crystalloid Preload on Hemodynamics after Pneumoperitoneum in Laparoscopically-Assisted Vaginal Hysterectomy (LAVH).
Hea Jo Yoon, Soo Mie Kim
Department of Anesthesiology and Pain Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea. heajo7890@hanmail.net
Abstract
BACKGROUND
Pneumoperitoneum and head-down tilt during a laparoscopic hysterectomy causes significant alterations in the hemodynamics including decreased cardiac output. The aim of this study was to evaluate the effects of a crystalloid preload on the hemodynamics after a hysterectomy (LAVH).
METHODS
The patients were randomized to receive either no crystalloid fluid preload (control group: 29 women) or 10 ml/kg of a crystalloid fluid preload over 10 min (preloading group: 30 women) before the pneumoperitoneum. The hemodynamic parameters were measured before inducing anesthesia, immediately after the tracheal intubation, before the skin incision, and 2, 5, 10, 20, and 30 min after the pneumoperitoneum with CO2 with noninvasive cardiac output measurements using the partial CO2 rebreathing method.
RESULTS
The cardiac index (CI) was reduced 2 and 5 min after the pneumoperitoneum, and then returned to normal. There were no significant differences in the CI after the pneumoperitoneum between the two groups (P<0.05).
CONCLUSIONS
The administration of a 10 ml/kg crystalloid preload did not attenuate the decrease in the CI after pneumoperitoneum.
Key Words: cardiac index; laparoscopically-assisted vaginal hysterectomy; partial CO2 rebreathing method; pneumoperitoneum; preload


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