Haemodynamic changes during laparoscopic anterior fundoplication measured by trans-oesophageal Doppler ultrasound.
We investigated the cardiovascular effects of pneumoperitoneum and steep head-up tilt during laparoscopic fundoplication using an intra-oesophageal Doppler ultrasound probe. Repositioning of the probe proved sufficient to maintain the signal throughout the procedure despite the pneumomediastinum. There was a statistically significant increase in mean arterial blood pressure and a fall in stroke distance but not in systemic vascular resistance. Increasing or decreasing the blood pressure with drugs improved stroke distance. The oesophageal Doppler ultrasound proved a satisfactory method for assessing cardiovascular changes during fundoplication.
Dickson
R E
RE
Department of Anaesthesia, Grampian University Hospitals NHS Trust, Aberdeen, UK.
Robertson
E A
EA
Krukowski
Z H
ZH
D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D002319:Cardiovascular System / Q000000981:diagnostic imaging*; D005240:Feasibility Studies; D018662:Fundoplication; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D008991:Monitoring, Physiologic; D011027:Pneumoperitoneum / Q000150:complications*; D013318:Stroke Volume / Q000502:physiology*; D018608:Ultrasonography, Doppler / Q000592:standards*; D014655:Vascular Resistance / Q000502:physiology*