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SEARCH RESULTS FOR: Anesthetic-Considerations-Laparoscopic-Abdominal-Surgery

Anesthetic Considerations Laparoscopic Abdominal Surgery

Anesthetic Considerations:
Laparoscopic abdominal surgery – healthy adult
Authors: Madison Amyotte, Tracey Rice, Priyanka Grewal, Luiza Radu Reviewers: Jasleen Brar, Leyla Baghirzada* * MD at time of publication
Hypercarbia (↑ CO2 in bloodstream)
Cardiovascular Effects
Positional
Pneumoperitoneum (introduction of gas eg. CO2 in the abdominal cavity for easier access to organs during laparoscopy)
Systemic vasodilation
↓ Systemic vascular resistance
↑ Systemic blood flow & oxygen delivery
Respiratory acidosis
Acidosis leads to ↓ cardiac contractility
Arrhythmia
Cardiac arrest
Reverse Trendelenburg positioning of patient (patient supine with head of OR table ↑)
↑ Venous pooling (accumulation of blood in veins)
↓ Venous return (blood returning to the heart)
↓ Preload
↓ Blood pressure
Trendelenburg positioning of patient (patient supine with head of OR table ↓)
Low fluid status
Compression of large abdominal vessels
↓ Preload
↓ Blood pressure
High fluid status
↑ Venous return (blood returning to the heart)
↑ Preload (ventricle filling pressure prior to contraction)
↑ Blood pressure
↑ Venous return
↑ Preload
↑ Blood pressure
Vagus nerve stimulation
Bradyarrhythmia (slow and irregular heart rate)
Asystole (absence of electrical activity and contractility of the heart)
↑ Cerebral blood flow
Cephalad (upward) displacement of diaphragm & compression of thoracic cavity
↓ Functional residual capacity (volume remaining after expiration) & pulmonary compliance
↓ Tidal volumes (air inhaled per breath)
Atelectasis (partial or full collapse of lung)
V/Q mismatch
(lung ventilation & perfusion imbalance)
Respiratory Effects
↑ Intraocular pressure (e.g. papilledema)
Ophthalmic compromise (visual system impairment)
↑ Intracranial pressure
Compression of renal vessels à↓ Renal blood flow
Release of catecholamines (norepinephrine & dopamine)
Renin angiotensin aldosterone system activation
Aldosterone & vasopressin release
↑ Blood pressure Renal System Effects
Neurologic Effects
Legend:
Pathophysiology
Mechanism
Sign/Symptom/Lab Finding
Complications
Published Nov 25, 2024on www.thecalgaryguide.com