Siekmann U, Dimler H
Frauenklinik der Krankenanstalten Konstanz.
Zentralbl Gynakol. 1989;111(2):99-109.
In 57 patients the effects of various stages during routine laparoscopy (induction of anaesthesia, intraabdominal insufflation of carbon dioxide, changes in body position) on cardiac performance were investigated. For the measurement of cardiac output we used the noninvasive thoracic impedance cardiography. After induction of anaesthesia and with terminated CO2 insufflation cardiac index significantly decreased compared to the reference values prior to surgical intervention (3.21 L/m2 vs. 1.96 L/m2; p less than 0.0001). At the end of laparoscopy in Trendelenburg position there was a slight increase in cardiac index with 2.26 L/m2. After the patients had been returned to the horizontal position and the abdomen was then deflated cardiac index almost reached the values at the beginning of laparoscopy. We demonstrated a high reproducibility in cardiac output measurements using impedance cardiography when comparing the respective values 24 hours prior to laparoscopy and those results investigated 24-48 hours after the surgical intervention. With regard to clinical situations of hypovolemia, f.e. ruptured ectopic pregnancies it is evident that the described alterations in cardiac performance should be considered.
在57例患者中，研究了常规腹腔镜检查各阶段（麻醉诱导、二氧化碳气腹、体位改变）对心脏功能的影响。我们使用无创胸阻抗心动图测量心输出量。麻醉诱导后且二氧化碳气腹结束时，与手术干预前的参考值相比，心脏指数显著降低（3.21L/m²对1.96L/m²；p＜0.0001）。在腹腔镜检查结束时，处于头低脚高位时心脏指数略有升高，为2.26L/m²。患者恢复到平卧位且腹部放气后，心脏指数几乎达到腹腔镜检查开始时的值。当比较腹腔镜检查前24小时的各自值与手术干预后24 - 48小时研究的结果时，我们证明了使用阻抗心动图测量心输出量具有高度可重复性。对于低血容量的临床情况，例如异位妊娠破裂，显然应考虑所描述的心脏功能改变。
