Effects of CO2 pneumoperitoneum on the basilar artery.
BACKGROUND
Laparoscopic surgery provides many benefits to the patients. The purpose of this study was to evaluate cerebral blood flow changes and the possibility of ischemia-reperfusion injury occurring during carbon dioxide (CO(2)) pneumoperitoneum.


METHODS
Forty-eight New Zealand white rabbits were divided into four experimental and two control groups. Rabbits were subjected to CO(2) pneumoperitoneum with an intraabdominal pressure of 8 and 15 mmHg for 60 or 180 min as designed for experimental groups. We then assessed the changes in physiological and transcranial Doppler ultrasonographic parameters, as well as brain malondialdehyde levels.


RESULTS
Transcranial Doppler sonography of the basilar artery revealed elevated mean velocity and decreased resistance index and pulsatility index values with the longer-duration and higher-pressure CO(2) pneumoperitoneum. However, there were no statistically significant difference in m alondialdehyde values.


CONCLUSIONS
Elevated intraabdominal pressure by CO(2)-pneumoperitoneum, which does not lead to ischemia-reperfusion injury of the brain tissue, results in increased cerebral blood flow and reduced cerebrovascular resistance as an autoregulatory cerebral answer for CO(2).
Erkan
N
N
Department of General Surgery, Dokuz Eylul University Medical School Hospital, 35350 Uckuyular, Izmir, Turkey. naziferkan@superonline.com
Gokmen
N
N
Goktay
A Y
AY
Erbayraktar
S
S
Taplu
A
A
Tokgoz
Z
Z
Astarcioglu
I
I
D000818:Animals; D001488:Basilar Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001921:Brain / Q000378:metabolism*; D002245:Carbon Dioxide / Q000493:pharmacokinetics; D005260:Female; D006439:Hemodynamics; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008315:Malondialdehyde / Q000378:metabolism*; D011028:Pneumoperitoneum, Artificial / Q000009:adverse effects*; D011673:Pulsatile Flow; D011817:Rabbits; D015427:Reperfusion Injury / Q000175:diagnosis / Q000209:etiology*; D014463:Ultrasonography
D002245:Carbon Dioxide; D008315:Malondialdehyde