복강경하 담낭절제술시 혈역학적 변화 및 Catecholamine 치의 변화

In the last decade, advances in laparoscopic equipment have allowed the development of laparosopic surgical treatment for gynecologic affection. Intraabdominal endoscopy can be extended safely for cholecystectomy. Patients undergoing laparoscopy under general anesthesia exhibit various hemodynamic and blood gas change. To analyze the physiologic mechanisms of these hemodynamic effect of laparoscopic surgery during general anesthesia, the change of mean arterial blood pressure, heart rate, end tidal carbon dioxide and plasma catecholamine were studied. Ten patients undergoing cholecystectomy by means of laparoscopy were selected randomly. Measurements of the above parameters were made about 10 minutes after tracheal intubation when the conditon of the patients stabilized(control), shortly after completion of insufflation of peritoneal cavity with carbon dioxide, 30 minutes after insufflation of carbon dioxide and after deflation of carbon dioxide. There were significantly increased mean arterial pressure, end tidal carbon dioxide, plasma epinephrine, norepinephrine during CO2 insufflation into peritoneaf cavity and increased there after with deflation of CO from the peritoneal cavity in laparoscopic cholecystectomy. In conclusion, these hemodynamic parameter changes seem to be correlated to the increased catecholamine release which was caused by sympathetic stimulation during the laparoscopic cholecystectomy.