Impact of gasless laparoscopy on circulation, respiration, stress response, and other complications in gynecological geriatrics

摘要

This study aimed to explore the impact of gasless laparoscopy on circulation, respiration, stress response and other complications in gynecological surgery for old female patients. 40 patients (American Society of Anesthesiologists II-III, 60-70y) scheduled for elective gynecological laparoscopy were divided into non-pneumoperitoneum group (NP) and pneumoperitoneum group (P). All patients included were monitored for Compliance, Ppeak, Ppalt, MAP, CVP, HR, Ssubp/subOsub2/sub, blood gas analysis (pH, Psuba/subCOsub2/sub, and Psuba/subOsub2/sub), serum cortisol, TNF-α, and IL-6. There were significant differences in bowel tones recovery, postoperative shoulder pain, nausea, and vomiting between two groups (P < 0.05). In the P group, the levels of CVP, and Ppeak and Ppalt at both 10 minutes and 30 minutes after suspension/pneumoperitoneum were significantly higher than those in NP group (P < 0.05). When it came to Compliance, this trend was reversed (P < 0.05). As surgery was conducted, the plasma concentrations of cortisol, IL-6 and TNF-α in the P group were higher than those in the NP group (P < 0.05). Thus, for gynecological diseases of geriatrics, the effect on respiratory and circulatory function is less significant of gasless laparoscopy than in pneumoperitoneum. The stress response, recovery of bowl tone, should pain, nausea, and vomiting after surgery in gasless laparoscopy is improved than in pneumoperitoneum.