Abstract
We compared left ventricular function using transesophageal echocardiography (TEE) in 11 patients undergoing laparoscopic cholecystectomy (LSC) inflated by carbon dioxide (inflation group) and 9 patients undergoing LSC by abdominal wall lifting (lifting group). The TEE probe was inserted after anesthesia induction and anesthesia was maintained with nitrous oxide-oxygen-isoflurane. We measured blood pressure, heart rate, stroke volume (SV), left ventricular ejection fraction (EF), E wave velocity, A wave velocity and A/E ratio by TEE at the following time points, after induction, after gas inflation (abdominal wall lifting), after head-up position, 30min after inflation (lifting), and 10min after deflation (falling).
Inflation in groups SV and EF significantly decreased compared to control values and the lifting group during inflation and head-up position. A/E ratio significantly increased compared to control values and the lifting group 30min after inflation. The simple regression coefficients between SV and A/E ratio were -0.451 (p<0.01) in the inflation group and -1.191 (p=0.2099) in the lifting group. A though many factors (eg. carbon dioxide, reduced venous return etc.) affect cardiac function in LSC, in this study we suggest that LV diastolic dysfunction during carbon dioxide inflation LSC may contribute to the reduction of SV.
