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2021, Number 2

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Rev Mex Cir Endoscop 2021; 22 (2)

Physiologic changes caused by patient's position and pneumoperitoneum during laparoscopic procedures

Gómez-Nieto GM, Nando-Villicaña CC, Achar-Farca T

Language: Spanish
References: 15
Page: 77-83
PDF size: 209.94 Kb.


ABSTRACT

Introduction: Laparoscopic surgery has become more common with time due to providing a reduction of postoperative pain and faster recovery times, although it is also related to important hemodynamic effects, which is why a profound comprehension of these physiopathologic changes is fundamental to provide an optimal anesthetic approach. Objectives: Creating a review to describe the principal physiologic changes secondary to the position used and the effects due to the insufflation of the abdomen, as well as understanding the importance of knowing these effects by the entire surgical team. Material and methods: A bibliographic search was done using the MeSH terms to identify clue articles (pneumoperitoneum, laparoscopic surgery, hemodynamic changes). We also used a cross reference with said articles. Results: Patient positioning and abdominal insufflation can induce physiopathologic changes that range from hemodynamic, pulmonary, renal, splanchnic to endocrine alterations, which will be present during the entire perioperative period in patients who will undergo laparoscopic surgery. Conclusions: Perioperative management for the estimation and reduction of morbimortality risk secondary to surgery and/or anesthetic management for laparoscopic procedures should be based on the knowledge of the physiopathologic changes induced by the combination of general anesthesia, abdominal insufflation and patient positioning.


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