지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 저널정보
- 대한마취통증의학회(구 대한마취과학회) Korean Journal of Anesthesiology Korean Journal of Anesthesiology Vol.50 No.1
- 발행연도
- 2006.1
- 수록면
- 20 - 24 (5page)
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Background: Although major CO2 gas embolism has occurred rarely during laparoscopic cholecystectomy (LC), the incidence of less severe episodes of CO2 embolism is unknown. It is also possible that such gas embolism, if present, could affect to cardiorespiratory variables. This study was designed to assess the incidence of subclinical embolic events using transesophageal echocardiography (TEE) and to evaluate the related hemodynamic consequence during LC. Methods: With IRB approval, 20 patients undergoing LC were studied. The long axis four chamber view was obtained continuously, except for predetermined intervals where the transgastric short axis view was obtained to derive ejection fraction (EF). Heart rate, mean arterial pressure, O2 saturation, and end-tidal CO2 were monitored. Statistical analysis was performed using multivariated ANOVA and unpaired Student's t-test. P ＜ 0.05 was considered significant. Results: We observed gas embolism in 4/20 patients during CO2 insufflation and 20/20 patients during gallbladder (GB) dissection. There was no significant difference in cardiorespiratory variables between embolic and nonembolic patients during insufflation. Also there was no significant difference in cardiorespiratory variation in all patients with embolism between before and after GB dissection. EF decreased significantly after insufflation (P = 0.002) and was recovered after exsufflation (P = 0.001). This can be explained by increase in systemic vascular resistance (SVR). Conclusions: Embolic events commonly occur during CO2 insufflation and GB dissection without cardiorespiratory instability. Although embolic event itself didn't affect the hemodynamic variables, peritoneal insufflation increased SVR and decreased EF. We should pay attention to patients undergoing LC who have decreased cardiac function and also prepare for serious CO2 embolic event. (Korean J Anesthesiol 2006; 50: 20～4)
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