Eun Ju Kim; Haesang Yoon

doi:10.4040/jkan.2010.40.3.433

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Original Article
The Effects of Pneumoperitoneum on Heart Rate, Mean Arterial Blood Pressure and Cardiac Output of Hypertensive Patients during Laparoscopic Colectomy: Eun Ju Kim, Haesang Yoon; Journal of Korean Academy of Nursing 2010;40(3):433-441.
DOI: https://doi.org/10.4040/jkan.2010.40.3.433
Published online: June 30, 2010

¹Nurse Anesthetist, Department of Nursing, National Cancer Center, Ilsan, Korea.

²Professor, Department of Nursing, Gachon University of Medicine & Science, Incheon, Korea.

Address reprint requests to: Yoon, Haesang. Department of Nursing, Gachon University of Medicine & Science, 534-2 Yeonsu-dong, Yeonsu-gu, Incheon 406-812, Korea. Tel: 82-32-820-4212, Fax: 82-32-820-4201, hsyoon@gachon.ac.kr

• Received: December 7, 2009 • Accepted: June 15, 2010

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Abstract
NOTES
REFERENCES

Abstract

Purpose
This study was performed to identify effects of pneumoperitoneum on hemodynamic changes of hypertensive patients undergoing laparoscopic colectomy under general anesthesia.
Methods
Data collection was done from January 2 to June 10, 2008. Seventy-six patients, including 38 hypertensive patients, who had taken antihypertensive drugs more than 1 month and 38 normotensive patients undergoing laparoscopic colectomy were enrolled in this study. The hemodynamic parameters were heart rate (HR), mean arterial pressure (MAP) and cardiac output (CO) which were measured 7 times from before induction of anesthesia to 5 min after deflation of the pneumoperitoneum. Collected data were analyzed using Repeated Measures ANOVA and Bonferroni comparison method.
Results
HR in the hypertensive group was significantly decreased at deflation of the pneumoperitoneum and 5 min after deflation of the pneumoperitoneum (p=.012). MAP in the hypertensive group was not different from the normotensive group (p=.756). CO in hypertensive group was significantly lower than normotensive group (p<.001) from immediately after pneumoperitoneum to 5 min after deflation of the pneumoperitoneum.
Conclusion
The results indicate that pneumoperitoneum during laparoscopic surgery does not lead to clinically negative hemodynamic changes in heart rate, mean arterial pressure or cardiac output of hypertensive patients, who have taken antihypertensive drugs for more than 1 month.
Keywords: Pneumoperitoneum; Hypertension; Heart rate; Blood pressure; Cardiac output

This study is a part of master's thesis.

REFERENCES

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Figure 1

Heart rate between hypertensive and normotensive group (N=76).

^***p<.001; ^†comparison between before induction and each time; ^‡comparison between hypertensive and normotensive group; G*T=Group*Time.

Time 1=before induction; Time 2=15 min after induction; Time 3=right after pneumoperitoneum; Time 4=10 min after pneumoperitoneum; Time 5=20 min after pneumoperitoneum; Time 6=right after deflation; Time 7=5 min after deflation; Score=Mean±SD.

Figure 2

Mean arterial pressure between hypertensive and normotensive group (N=76).

^**p<.01; ^***p<.001; ^†comparison between before induction and each time; G*T=Group*Time.

Time 1=before induction; Time 2=15 min after induction; Time 3= right after pneumoperitoneum; Time 4=10 min after pneumoperitoneum; Time 5=20 min after pneumoperitoneum; Time 6=right after deflation; Time 7=5 min after deflation; Score=Mean±SD.

Figure 3

Cardiac output between hypertensive and normotensive group (N=76).

^*p<.05; ^***p<.001; ^†comparison between before induction and each time; ^‡comparison between hypertensive and normotensive group; G*T=Group*Time.

Time 1=right after induction; Time 2=15 min after induction; Time 3=right after pneumoperitoneum; Time 4=10 min after pneumoperitoneum; Time 5=20 min after pneumoperitoneum; Time 6=right after deflation; Time 7=5 min after deflation; Score=Mean±SD.

Table 1

Homogeneity Test for Physiological Characteristics (N=76)

BMI=Body mass index; ASA=American Society of Anesthesiology; ACE=angiotensin converting enzyme; ARB=Angiotensin II Receptor Blocker.

Figure & Data

REFERENCES

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The Effects of Pneumoperitoneum on Heart Rate, Mean Arterial Blood Pressure and Cardiac Output of Hypertensive Patients during Laparoscopic Colectomy

J Korean Acad Nurs. 2010;40(3):433-441. Published online June 30, 2010

DOI: https://doi.org/10.4040/jkan.2010.40.3.433

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The Effects of Pneumoperitoneum on Heart Rate, Mean Arterial Blood Pressure and Cardiac Output of Hypertensive Patients during Laparoscopic Colectomy

Figure 1 Heart rate between hypertensive and normotensive group (N=76). ***p<.001; †comparison between before induction and each time; ‡comparison between hypertensive and normotensive group; G*T=Group*Time. Time 1=before induction; Time 2=15 min after induction; Time 3=right after pneumoperitoneum; Time 4=10 min after pneumoperitoneum; Time 5=20 min after pneumoperitoneum; Time 6=right after deflation; Time 7=5 min after deflation; Score=Mean±SD.

Figure 2 Mean arterial pressure between hypertensive and normotensive group (N=76). **p<.01; ***p<.001; †comparison between before induction and each time; G*T=Group*Time. Time 1=before induction; Time 2=15 min after induction; Time 3= right after pneumoperitoneum; Time 4=10 min after pneumoperitoneum; Time 5=20 min after pneumoperitoneum; Time 6=right after deflation; Time 7=5 min after deflation; Score=Mean±SD.

Figure 3 Cardiac output between hypertensive and normotensive group (N=76). *p<.05; ***p<.001; †comparison between before induction and each time; ‡comparison between hypertensive and normotensive group; G*T=Group*Time. Time 1=right after induction; Time 2=15 min after induction; Time 3=right after pneumoperitoneum; Time 4=10 min after pneumoperitoneum; Time 5=20 min after pneumoperitoneum; Time 6=right after deflation; Time 7=5 min after deflation; Score=Mean±SD.

Figure 1

Figure 2

Figure 3

The Effects of Pneumoperitoneum on Heart Rate, Mean Arterial Blood Pressure and Cardiac Output of Hypertensive Patients during Laparoscopic Colectomy

Table 1

Homogeneity Test for Physiological Characteristics (N=76)

BMI=Body mass index; ASA=American Society of Anesthesiology; ACE=angiotensin converting enzyme; ARB=Angiotensin II Receptor Blocker.

Table 1 Homogeneity Test for Physiological Characteristics (N=76)

BMI=Body mass index; ASA=American Society of Anesthesiology; ACE=angiotensin converting enzyme; ARB=Angiotensin II Receptor Blocker.