title: The effects of 3 different intra-abdominal pressures on the thromboelastographic profile during laparoscopic cholecystectomy.
abstract: OBJECTIVE
  The aim was to determine the influence of the pneumoperitoneum at 10, 13, and 16 mm Hg on thromboelastograph (TEG) in laparoscopic cholecystectomy.
  
  
  METHODS
  Sixty patients were randomly allocated to 3 groups. The abdomen was insufflated with carbon dioxide to 10 mm Hg (group 1), 13 mm Hg (group 2), and 16 mm Hg (group 3) intra-abdominal pressures. We evaluated changes in the TEG values [reaction time (R), maximum amplitude (MA), α-angle, K time] preoperatively, intraoperatively, and postoperatively.
  
  
  RESULTS
  In the postoperative 24th hour, the R-value was significantly lower in group 3 than that in group 1 and group 2 (P<0.05). We found increased values of MA intraoperative 30th minute and postoperative 24th hour in group 3 with respect to group 1 (P<0.05) and postoperative 24th hour, and the MA value in group 3 was significantly higher than those of group 2 (P<0.05). In group 3, the α-angle was significantly higher than that of group 1 and group 2 at intraoperative 30th minute and postoperative 24th hour (P<0.05). In postoperative 24th hour, the K-value was significantly lower in group 3 than in group 2 and group 1 (P<0.05).
  
  
  CONCLUSIONS
  Laparoscopy with pneumoperitoneum at pressures of 10 and 13 mm Hg did not alter the TEG values and low intra-abdominal pressure must be used for peritoneal insufflation.
authors.affiliation: Department of Anesthesiology and Reanimation, Meram Medical Faculty, Selçuk University, Konya, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Topal
authors.forename: Jale Bengi
authors.initials: JB
authors.lastname: Celik
authors.forename: Ahmet
authors.initials: A
authors.lastname: Tekin
authors.forename: Ali
authors.initials: A
authors.lastname: Yüceaktaş
authors.forename: Seref
authors.initials: S
authors.lastname: Otelcioğlu
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001777:Blood Coagulation / Q000502:physiology*; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D002769:Cholelithiasis / Q000097:blood* / Q000601:surgery; D004548:Elasticity / Q000502:physiology; D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care; D011028:Pneumoperitoneum, Artificial / Q000379:methods*; D011312:Pressure; D011446:Prospective Studies; D013916:Thrombelastography / Q000706:statistics & numerical data; D013927:Thrombosis / Q000517:prevention & control