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pneumoperitoneum effects

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https://www.readbyqxmd.com/read/27889843/a-randomized-comparison-of-the-ambu-auragain-versus-the-lma-supreme-in-patients-undergoing-gynaecologic-laparoscopic-surgery
#1
Ana M Lopez, Merce Agusti, Pedro Gambus, Montserrat Pons, Teresa Anglada, Ricard Valero
Second generation supraglottic airway devices providing high seal airway pressures are suitable for patients undergoing gynecologic laparoscopy. We compared the seal pressure achieved by the new Ambu AuraGain™ versus LMA Supreme™ following pneumoperitoneum in the Trendelenburg position. Sixty female patients were randomly allocated to ventilation with either the AuraGain or the Supreme. A target-controlled system was used to administer total intravenous anesthesia. Intracuff pressure was maintained below 60 cm H2O...
November 26, 2016: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/27889250/positive-end-expiratory-pressure-does-not-decrease-cardiac-output-during-laparoscopic-liver-surgery-a-prospective-observational-evaluation
#2
Denis Bernard, Antoine Brandely, Olivier Scatton, Pierre Schoeffler, Emmanuel Futier, Thomas Lescot, Marc Beaussier
BACKGROUND: Positive end-expiratory pressure (PEEP) has beneficial pulmonary effects but may worsen the hemodynamic repercussions induced by pneumoperitoneum (PNP) in patients undergoing liver laparoscopic liver resection. However, by the increase of intraluminal vena cava (VC) pressures, PEEP may prevent PNP-induced VC collapse. The aim of this original article was to test the validity of this hypothesis. METHODS: After IRB approval and written inform consents, 20 patients were prospectively evaluated...
November 23, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/27875107/the-effect-of-elevated-intra-abdominal-pressure-on-tlr4-signaling-in-intestinal-mucosa-and-on-intestinal-bacterial-translocation-in-a-rat
#3
Adam Strier, Dragan Kravarusic, Arnold G Coran, Isaac Srugo, Nir Bitterman, Tatiana Dorfman, Yulia Pollak, Ibrahim Matter, Igor Sukhotnik
BACKGROUND: Recent evidence suggests that elevated intra-abdominal pressure (IAP) may adversely affect the intestinal barrier function. Toll-like receptor 4 (TLR-4) is responsible for the recognition of bacterial endotoxin or lipopolysaccharide and for initiation of the Gram-negative septic shock syndrome. The objective of the current study was to determine the effects of elevated IAP on intestinal bacterial translocation (BT) and TLR-4 signaling in intestinal mucosa in a rat model. METHODS: Male Sprague-Dawley rats were randomly assigned to one of two experimental groups: sham animals (Sham) and IAP animals who were subjected to a 15 mmHg pressure pneumoperitoneum for 30 minutes...
November 22, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27842708/-effects-of-different-levels-of-end-expiratory-pressure-on-hemodynamic-respiratory-mechanics-and-systemic-stress-response-during-laparoscopic-cholecystectomy
#4
Oznur Sen, Yasemin Erdogan Doventas
OBJECTIVE: General anesthesia causes reduction of functional residual capacity. And this decrease can lead to atelectasis and intrapulmonary shunting in the lung. In this study we want to evaluate the effects of 5 and 10cmH2O PEEP levels on gas exchange, hemodynamic, respiratory mechanics and systemic stress response in laparoscopic cholecystectomy. METHODS: American Society of Anesthesiologist I-II physical status 43 patients scheduled for laparoscopic cholecystectomy were randomly selected to receive external PEEP of 5cmH2O (PEEP 5 group) or 10cmH2O PEEP (PEEP 10 group) during pneumoperitoneum...
November 11, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/27821836/effects-of-combined-general-epidural-anesthesia-on-hemodynamics-respiratory-function-and-stress-hormone-levels-in-patients-with-ovarian-neoplasm-undergoing-laparoscopy
#5
Qiang Xu, Hao Zhang, Yan-Mei Zhu, Nian-Jun Shi
BACKGROUND The aim of this study was to evaluate the influence of combined general/epidural anesthesia (GEA) on hemodynamics, respiratory function and stress hormone levels in patients with ovarian neoplasm undergoing laparoscopy. MATERIAL AND METHODS A total of 177 patients with ovarian neoplasm (screened by inclusion/exclusion criteria) receiving laparoscopy were divided into groups G (general anesthesia alone), L1.0 (GEA with 1.0% lidocaine), and L1.5 (GEA with 1.5% lidocaine). Hemodynamics, respiratory parameters and stress hormone levels in the 3 groups were recorded and analyzed...
November 8, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27809635/evaluation-of-robot-assisted-laparoscopic-versus-open-cystectomy-and-effect-of-carbon-dioxide-pneumoperitoneum-on-histopathological-findings-in-ureteroenteric-anastomoses-results-from-an-experimental-randomized-porcine-study
#6
Pernille Skjold Kingo, Thormod Mønsted Rasmussen, Rikke Nørregaard, Michael Borre, Søren Høyer, Jørgen Bjerggaard Jensen
OBJECTIVE: The aim of this study was to investigate the histopathology of ureteroenteric anastomoses (UEAs) after radical cystectomy (RC) with an ileal conduit in a porcine model using different surgical techniques. The study also evaluated the potential anti-inflammatory effect of preoperative carbon dioxide-pneumoperitoneum (CO2P). MATERIALS AND METHODS: Forty female Danish Landrace pigs were randomized to four groups: three intervention groups [open surgery ± prior CO2P and robot-assisted laparoscopic cystectomy (RALC)], all subjected to RC and an ileal conduit, and one control group...
November 4, 2016: Scandinavian Journal of Urology
https://www.readbyqxmd.com/read/27771984/the-effects-of-adding-ischemic-preconditioning-during-desflurane-inhalation-anesthesia-or-propofol-total-intravenous-anesthesia-on-pneumoperitoneum-induced-oxidative-stress
#7
Safinaz Karabayirli, Onder Surgit, Hulya Kasikara, Cemile Koca Bicer, Merve Ergin, Ruveyda Irem Demircioglu, Bunyamin Muslu
BACKGROUND: The aim of the study was to explore the differences in oxidative stress during anesthesia with desflurane/N2O or propofol/remifentanil in patients undergoing laparoscopic cholecystectomy and additionally to evaluate the differential effects of desflurane and propofol on ischemic preconditioning (IP). MATERIALS AND METHODS: One hundred patients were randomly allocated to four groups. For anesthesia maintenance, the inhalation group (Group I) and the inhalation plus IP group (Group IIP) received desflurane at an end-tidal concentration of 4-6 vol% in oxygen/N2O, and the TIVA group (Group T) and TIVA plus IP group (Group TIP) received infusions of propofol and remifentanil...
October 24, 2016: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/27760282/heated-insufflation-with-or-without-humidification-for-laparoscopic-abdominal-surgery
#8
REVIEW
Daniel W Birch, Jerry T Dang, Noah J Switzer, Namdar Manouchehri, Xinzhe Shi, Ghassan Hadi, Shahzeer Karmali
BACKGROUND: Intraoperative hypothermia during both open and laparoscopic abdominal surgery may be associated with adverse events. For laparoscopic abdominal surgery, the use of heated insufflation systems for establishing pneumoperitoneum has been described to prevent hypothermia. Humidification of the insufflated gas is also possible. Past studies on heated insufflation have shown inconclusive results with regards to maintenance of core temperature and reduction of postoperative pain and recovery times...
October 19, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27731820/effects-of-dexmedetomidine-on-the-deformability-of-erythrocyte-in-patients-with-laparoscopic-cholecystectomy
#9
Xming Yang, Jie Xie, Jun Liu, Tao Wang
This study aims to study the impact of dexmedetomidine on the deformability of erythrocyte in patients with laparoscopic cholecystectomy. 40 patients scheduled for laparoscopic cholecystectomy were randomly divided into 2 groups: Dexmedetomidine group (0.5µg/kg loading within 10 min and 0.5μg•kg-1•h-1maintenance to the end of pneumoperitoneum, n=20, Group A) and control group (normal saline at the identical, n=20, Group B). The induction and maintenance of anesthesia of two groups were identical. Erythrocyte deformability index (EI) and haematocrit (Hct) were assayed before anesthesia and after the operation...
September 2016: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/27724965/comparison-of-the-impact-of-prolonged-low-pressure-and-standard-pressure-pneumoperitoneum-on-myocardial-injury-after-robot-assisted-surgery-in-the-trendelenburg-position-study-protocol-for-a-randomized-controlled-trial
#10
Xixue Zhang, Jionglin Wei, Xiaoxing Song, Yuhao Zhang, Weiqing Qian, Lu Sheng, Zhoujun Shen, Lvjun Yang, Rong Dong, Weidong Gu
BACKGROUND: Robot-assisted laparoscopic radical prostatectomy and robot-assisted radical cystectomy have gradually become the preferred choices for urologists as they allow surgeons to perform complex procedures more precisely and effectively. The pneumoperitoneum, which is normally applied in these surgeries to provide visual clarity and space to perform the procedure, may cause hemodynamic disturbance, potentially myocardial injury. Thus surgeons have recently considered opting for the low-pressure pneumoperitoneum to lower this negative impact...
October 10, 2016: Trials
https://www.readbyqxmd.com/read/27687373/effect-of-depth-of-neuromuscular-blockade-on-the-abdominal-space-during-pneumoperitoneum-establishment-in-laparoscopic-surgery
#11
Javier Barrio, Carlos L Errando, Guillermo San Miguel, Boris I Salas, Juan Raga, José L Carrión, Jaime García-Ramón, Juan Gallego
STUDY OBJECTIVE: To evaluate the effect of neuromuscular blockade (NMB) upon the abdominal space during pneumoperitoneum establishment in laparoscopic surgery, comparing moderate NMB and deep NMB. DESIGN: Prospective, randomized, crossover clinical trial. SETTING: Operating room. PATIENTS: Seventy-six American Society of Anesthesiologists 1 to 2 patients scheduled for elective laparoscopic surgery. INTERVENTIONS: Two independent evaluations were performed at the establishment of pneumoperitoneum for a preset intraabdominal pressures (IAPs) of 8 and 12 mm Hg, both during moderate NMB (train-of-four count, 1-3) and deep NMB (posttetanic count, <5)...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27687346/comparison-of-volume-controlled-ventilation-and-pressure-controlled-ventilation-volume-guaranteed-during-laparoscopic-surgery-in-trendelenburg-position
#12
Osama M Assad, Ayman A El Sayed, Mohamed A Khalil
STUDY OBJECTIVE: To analyze the effects of pressure-controlled ventilation-volume guaranteed (PCV-VG) and volume controlled ventilation (VCV) on airway pressures and respiratory and circulatory indicators during laparoscopic surgery in Trendelenburg position. DESIGN: Prospective randomized comparative clinical study. SETTING: Tertiary hospital. PATIENTS: Forty ASA physical status 1 and 2 patients who underwent elective laparoscopic surgery in Trendelenburg position...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27681819/intermittent-pneumatic-compression-in-laparoscopic-surgery-for-prevention-of-deep-vein-thrombosis-and-cellular-damage-from-iatrogenic-compartment-syndrome
#13
Maria Grazia Sederino, Giulia Casamassima, Rita Laforgia, Giovanni Balducci, Giuseppe Carbotta, Antonella Tromba
AIM: This study is aimed to evaluate the incidence of the postoperative deep vein thrombosis (DVT) and the cell damage from compartment iatrogenic syndrome, analyzing two groups of patients operated laparoscopically, one of which assisted with a Sequential Compression Device (SCD). MATERIAL OF STUDY: A patients' series submitted to laparoscopic surgery over a period at least 90 minutes. The venous flow in the lower limbs was detected with the Echo Colour Doppler method, and only one of the two groups was assisted with the SCD...
2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/27664874/a-laparoscopic-technique-of-partial-hepatectomy-in-the-rat
#14
Petros Ypsilantis, Constantinos Simopoulos
BACKGROUND: Laparoscopic partial hepatectomy is an increasingly applied technique in the treatment of liver tumors and in living donor transplantation. There is a need for establishing an animal model that would facilitate experimental research on the technique. The aim of the present study was to describe a safe and efficient laparoscopic technique of 70% partial hepatectomy in the rat. MATERIALS AND METHODS: Twenty-four male Wistar rats underwent either laparoscopic (group LAP-HEP) or open resection of the median and left lateral hepatic lobes (group HEP)...
October 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27651988/is-there-any-effect-of-pneumoperitoneum-pressure-on-coagulation-and-fibrinolysis-during-laparoscopic-cholecystectomy
#15
Turgut Donmez, Sinan Uzman, Dogan Yildirim, Adnan Hut, Huseyin Imam Avaroglu, Duygu Ayfer Erdem, Erdinc Cekic, Fazilet Erozgen
BACKGROUND: Laparoscopic cholecystectomies (LC) are generally performed in a 12 mmHg-pressured pneumoperitoneum in a slight sitting position. Considerable thromboembolism risk arises in this operation due to pneumoperitoneum, operation position and risk factors of patients. We aim to investigate the effect of pneumoperitoneum pressure on coagulation and fibrinolysis under general anesthesia. MATERIAL AND METHODS: Fifty American Society of Anesthesiologist (ASA) I-III patients who underwent elective LC without thromboprophlaxis were enrolled in this prospective study...
2016: PeerJ
https://www.readbyqxmd.com/read/27650270/long-term-outcomes-of-a-newly-developed-hybrid-metal-stent-for-eus-guided-biliary-drainage-with-videos
#16
Dong Hui Cho, Sang Soo Lee, Dongwook Oh, Tae Jun Song, Do Hyun Park, Dong Wan Seo, Sung Koo Lee, Myung-Hwan Kim
BACKGROUND AND AIMS: Although fully covered self-expandable metal stents (FCSEMSs) have been commonly used for EUS-guided biliary drainage (EUS-BD), FCSEMSs migration is a main limitation of this procedure. In the present study, we evaluated the technical and clinical success rates, adverse events and long-term outcomes of a newly developed hybrid stent that has been customized for EUS-BD. METHOD: From September 2011 to May 2015, a total of 54 consecutive patients with biliary obstruction were enrolled in this prospective, observational study...
September 17, 2016: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/27633440/safety-and-efficacy-of-poem-for-treatment-of-achalasia-a-systematic-review-of-the-literature
#17
Oscar M Crespin, Louis W C Liu, Ambica Parmar, Timothy D Jackson, Jemila Hamid, Eran Shlomovitz, Allan Okrainec
INTRODUCTION: Peroral endoscopic myotomy (POEM) is a novel intervention for the treatment of achalasia, which combines the advantages of endoscopic access and myotomy. The purpose of this study was to perform a systematic review of the literature to evaluate the efficacy and safety of POEM. METHODS: The systematic review was conducted following the PRISMA guidelines. Evidence-Based Medicine Reviews, Cochrane Central Register of Controlled Trials, Ovid MEDLINE (R) including in-process and non-indexed citations were searched for POEM studies using the keywords: esophageal achalasia, POEM, endoscopy, natural orifice surgery, laparoscopic Heller myotomy (LHM), and related terms...
September 15, 2016: Surgical Endoscopy
https://www.readbyqxmd.com/read/27577055/unexpected-hemorrhage-during-robot-assisted-laparoscopic-prostatectomy-a-case-report
#18
Shoko Nakano, Junko Nakahira, Toshiyuki Sawai, Noriko Kadono, Toshiaki Minami
BACKGROUND: Robot-assisted laparoscopic prostatectomy is increasingly performed as a minimally invasive option for patients with organ-confined prostate cancer. This technique offers several advantages over other surgical methods. However, concerns have been raised over the effects of the steep head-down tilt necessary during the procedure. We present a case in which head-down positioning and abdominal insufflation masked the signs of an intraoperative hemorrhage. CASE PRESENTATION: A 73-year-old Asian man developed severe hypotension caused by an unexpected hemorrhage during robot-assisted laparoscopic prostatectomy for prostate cancer...
2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27565964/a-comparative-analysis-of-the-effects-of-sevoflurane-and-propofol-on-cerebral-oxygenation-during-steep-trendelenburg-position-and-pneumoperitoneum-for-robotic-assisted-laparoscopic-prostatectomy
#19
Aya Doe, Motoi Kumagai, Yuichiro Tamura, Akira Sakai, Kenji Suzuki
PURPOSE: Steep Trendelenburg position and pneumoperitoneum during robotic-assisted laparoscopic prostatectomy (RALP) increase intracranial pressure (ICP) and may alter cerebral blood flow (CBF) and oxygenation. Volatile anesthetics and propofol have different effects on ICP, CBF, and cerebral metabolic rate and may have different impact on cerebral oxygenation during RALP. In this study, we measured jugular venous bulb oxygenation (SjO2) and regional oxygen saturation (SctO2) in patients undergoing RALP to evaluate cerebral oxygenation and compared the effects of sevoflurane and propofol...
December 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27553804/compliance-of-the-abdominal-wall-during-laparoscopic-insufflation
#20
Chuck Becker, Margaret A Plymale, John Wennergren, Crystal Totten, Kyle Stigall, J Scott Roth
BACKGROUND: To provide adequate workspace between the viscera and abdominal wall, insufflation with carbon dioxide is a common practice in laparoscopic surgeries. An insufflation pressure of 15 mmHg is considered to be safe in patients, but all insufflation pressures create perioperative and postoperative physiologic effects. As a composition of viscoelastic materials, the abdominal wall should distend in a predictable manner given the pressure of the pneumoperitoneum. The purpose of this study was to elucidate the relationship between degree of abdominal distention and the insufflation pressure, with the goal of determining factors which impact the compliance of the abdominal wall...
August 23, 2016: Surgical Endoscopy
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