The Effects of the Lateral Position on Cardiopulmonary Function During Laparoscopic Urological Surgery
- 1 October 1998
- journal article
- research article
- Published by Wolters Kluwer Health in Anesthesia & Analgesia
- Vol. 87 (4) , 925-930
- https://doi.org/10.1097/00000539-199810000-00034
Abstract
Laparoscopic urological surgery is usually performed transperitoneally with retroperitoneal insufflation of carbon dioxide (CO2) in the lateral position.We studied whether a difference in the side of lateral position affected hemodynamic and pulmonary functions during pneumoperitoneum. Fifteen patients (eight in the right and seven in the left lateral position) undergoing elective laparoscopic urological surgery were studied under general anesthesia. Hemodynamic variables and blood gas data were recorded. Before insufflation, mean arterial pressure (MAP), mean pulmonary arterial pressure (MPAP), central venous pressure (CVP), and pulmonary capillary wedge pressure (PCWP) in the right lateral position were higher than those in the left lateral position. Pneumoperitoneum increased MAP, MPAP, CVP, PCWP, and cardiac index but decreased systemic vascular resistance in the right lateral position. Similar changes occurred during pneumoperitoneum in the left lateral position, but the changes were less than those in the right lateral position. The respiratory index (PaO2/PAO2), intrapulmonary shunt, and SpO2 did not change during pneumoperitoneum in either lateral position. Changing the side of the lateral position affected hemodynamic function but did not affect pulmonary oxygenation during pneumoperitoneum. Implications: The right and left lateral positions produced different hemodynamic changes during laparoscopic urological surgery. The increases in preload and cardiac index and the decrease in systemic vascular resistance were greater in the right than in the left lateral position. Respiratory changes were not affected differently between the right and left lateral positions. (Anesth Analg 1998;87:925-30)Keywords
This publication has 21 references indexed in Scilit:
- Cardiopulmonary aspects of laparoscopic surgeryCurrent Opinion In Anesthesiology, 1996
- Cardiopulmonary function and laparoscopic cholecystectomyCanadian Journal of Anesthesia/Journal canadien d'anesthésie, 1995
- Pulmonary function during and following laparoscopyCurrent Opinion In Anesthesiology, 1994
- Laparoscopic CholecystectomyAnesthesia & Analgesia, 1993
- Laparoscopic adrenalectomy: The surgical technique and initial results of 13 casesMinimally Invasive Therapy, 1993
- METABOLIC AND RESPIRATORY CHANGES AFTER CHOLECYSTECTOMY PERFORMED VIA LAPAROTOMY OR LAPAROSCOPYBritish Journal of Anaesthesia, 1992
- Laparoscopic Nephrectomy: Initial Case ReportJournal of Urology, 1991
- Reduced postoperative hospitalization after laparoscopic cholecystectomyBritish Journal of Surgery, 1991
- Conventional Versus laparoscopic cholecystectomy and the randomized controlled trialBritish Journal of Surgery, 1991
- Hemodynamic Changes Associated with Various Surgical PositionsPublished by American Medical Association (AMA) ,1963