Hemodynamic, Ventilatory and Endocrintal Stress Responses Changes in Laparoscopic Cholecystectomy under Different Anesthetic Techniques

Abstract

Laparoscopy was introduced early in the 20th century and developed m the 1970s for gynecological procedures; its recent extension to gastrointestinal shrgical procedures has created neJ . interest and conkiderations in. anesthetic managel ,ment. • However, peritoneal insufllation with CO2, •• creat.mg a pneumoperitoneum necessary or aparo . scopy, induces intraoperative hemodynamic and ventilatory chnges which complicates anesthetic management. The position of the patient (head- down or head-up) required during these procedures also contributes to e changes . Three mai'n adverse effects which may occur during laparofcopy are: increase in PaCO2, pneumothorax although rare, and gas embolism. It is generally that hypercapnea observed .