[Changes in hemodynamic values in various phases of pelviscopy].

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.