IT_GS 1.8 Physiological changes associated with pneumoperitoneum and their implications for anaesthesia

Another practical LO for today. Miller’s Anaesthesia used to have a chapter devoted to this topic, but unfortunately it has vanished from the current edition. There is however a quite nice little section at the end of Chapter 21

Here is another brief overview of anaesthesia for laparoscopy. In the middle there is a section on the physiological changes. It is worth remembering that a number of the effects are worsened as the intra-abdominal pressure generated increases (one of the reasons for the alarm on the gas insufflation machine).

This chap (a male frigate bird) doesn’t have a pneumoperitoneum, but rather an inflated gular pouch – apparently irresistible if you are a female frigate bird. They can fly with that pouch inflated (I’ll show you a photo of that tomorrow)

OLYMPUS DIGITAL CAMERA

IT_1.8  Outline the physiological changes that occur with and the implications for anaesthetic management of pneumoperitoneum

Harking back to yesterday’s post what do you think the effect of pneumoperitoneum is likely to be on renal function?

A pneumoperitoneum causes activation of the sympathetic nervous system TRUE/FALSE

Release of a pneumoperitoneum may be associated the ischaemia-reperfusion injury TRUE/FALSE

Pneumoperitoneum may be associated with abdominal compartment syndrome TRUE/FALSE

Trendelenberg positioning can reverse some of the haemodynamic effects of pneumoperitoneum  TRUE/FALSE (what effect will it have on the respiratory consequences?)

Pnemoperitoneum reduces respiratory system compliance TRUE/FALSE

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