Intracranial blood flow during laparoscopic hysterectomy.
OBJECTIVE
To examine intracranial blood flow during major laparoscopic gynecologic operation and the effects of a deep Trendelenburg position and pneumoperitoneum on the flow.


METHODS
Fifteen patients scheduled for laparoscopic hysterectomy.


METHODS
Trans-cranial Doppler examination of blood flow velocity waveforms in the middle cerebral artery during operation.


RESULTS
Trendelenburg position and pneumoperitoneum were followed by a decrease in cardiac output and an increase of central venous pressure and pulmonary capillary wedge pressure. No significant changes in the pulsatility index or maximal or mean blood flow velocities in the middle cerebral artery occurred during operations. A negative correlation between percentual changes in the pulsatility index and mean arterial pressure existed.


CONCLUSIONS
Uncomplicated laparoscopic hysterectomy is not associated with harmful changes in intracranial circulation in spite of a Trendelenburg position, pneumoperitoneum and changes in the patient's extracranial hemodynamics.
Department of Obstetrics and Gynecology, University of Kuopio, Finland.
P
P
Kirkinen
E
E
Hirvonen
M
M
Kauko
S
S
Purhonen
L
L
Nuutinen
D000328:Adult; D001783:Blood Flow Velocity; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D007432:Intraoperative Period; D010535:Laparoscopy; D011027:Pneumoperitoneum; D017585:Ultrasonography, Doppler, Transcranial