[Hemodynamic changes during laparoscopic cholecystectomy under different anesthesia methods].

We measured cardiovascular changes associated with insufflation of carbon dioxide and the reverse Trendelenburg position during laparoscopic cholecystectomy. Twenty eight ASA I and II patients were assigned to three groups depending on the anesthesia method. Inhalation anesthesia (I) group (n = 10) was maintained with nitrous oxide-oxygen-isoflurane (GOI), fentanyl (F) group (n = 10) was maintained with GOI and fentanyl (4.8 +/- 0.9 micrograms . kg-1), and epidural (E) group (n = 8) was maintained with GOI and continuous epidural infusion (1.5% lidocaine, 5 ml . h-1). Swan-Gantz catheters were inserted to the patients in groups F and E. Heart rate and arterial blood pressure increased significantly in group I and this elevated pressure was difficult to control using even high concentrations in isoflurane. Heart rate, arterial blood pressure, right atrial pressure, pulmonary arterial pressure cardiac output, and systemic and pulmonary vascular resistance were not significantly changed in groups E and E. Stroke volume decreased significantly in group F after pneumoperitoneum. Our result showed that hemodynamics during laparoscopic cholecystectomy were the most stable in group E.