Background: Inspite of increasing the usage of laparoscopic techniques, there is still a lot of argument about multiple aspects of its techniques as regard the best method for accessing the peritoneal cavity by creating pneumo-peritoneumand Veress needle puncture which may have many effects on cerebral perfusion state and oxygen consumption.
DESIGN: A prospective, randomized clinical trial.
PARTICIPANTS: 40 patients scheduled for elective laparoscopic cholycystectomy surgery, 20 - 59 years old, of either sex ASA I - II.
INTERVENTIONS: After ethical approval, patients were randomly assigned into two groups to receive either : intraperitoneal pressure of 12 mmHg ( PL) group and ( PH) group: intraperitoneal pressure of 20 mmHg.
MAIN OUTCOME MEASURES: No significant differences in HR, SaO2 and Et.Co2 between both groups. MAP and CPP were lower in ( PH) group vs ( PL) group at 2nd intraop. reading. CPP at 2nd intraop. reading was lower in both group compared to basal value, MAP in ( PH) group was lower and JBP was higher at 2nd intraop. reading than basal value. PaO2 and (COER %) were lower in ( PH) vs, ( PL) group at 2nd intraop. reading, also PaO2 was lower in ( PH) compared to basal value at 2nd intraop. reading
Conclusions: During laparoscopic cholycystectomy.surgery, there is frequently reported alterations in cerebral blood flow and intracranial pressure. These changes affect cerebral perfusion pressure and thus may affect cerebral oxygenation.
Key words: Different levels artificial pneumoperitoneum pressure, cerebral perfusion pressure, laparoscopic cholycystectomy.
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