Mikami O, Kawakita S, Fujise K, Shingu K, Takahashi H, Matsuda T
Department of Urology, Kansai Medical University, Morigichi, Osaka, Japan.
J Urol. 1996 Apr;155(4):1368-71.
We evaluated plasma catecholamine levels during pneumoperitoneum in laparoscopic surgery.
Plasma epinephrine and norepinephrine were evaluated in 29 patients who underwent laparoscopic retroperitoneal surgery in a half lateral decubitus position (group 1) or laparoscopic varicocelectomy in a Trendelenburg position (group 2).
The levels of epinephrine and norepinephrine increased significantly 5 minutes after carbon dioxide insufflation compared to levels after Veress needle insertion and just before insufflation. The elevation of catecholamine levels during laparoscopic procedures was greater in group 1.
Our results indicate that carbon dioxide insufflation may cause catecholamine release during laparoscopic surgery. Careful monitoring of hemodynamics is mandatory at the beginning of the procedure.
我们评估了腹腔镜手术气腹期间的血浆儿茶酚胺水平。
对29例患者进行了血浆肾上腺素和去甲肾上腺素评估,这些患者分别接受了半侧卧位的腹腔镜腹膜后手术(第1组)或头低脚高位的腹腔镜精索静脉高位结扎术(第2组)。
与Veress针插入后及即将充气前的水平相比,二氧化碳充气5分钟后肾上腺素和去甲肾上腺素水平显著升高。第1组在腹腔镜手术过程中儿茶酚胺水平的升高幅度更大。
我们的结果表明,二氧化碳充气可能在腹腔镜手术期间导致儿茶酚胺释放。在手术开始时必须仔细监测血流动力学。