Analysis of Hemodynamic Changes Using Systolic Pressure Variation(SPV) Measurement by Tonometric Method During Laparoscopic Cholecystectomy.
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Systolic pressure variation (SPV), which is the difference between the maximal and minimal values of systolic blood pressure during one mechanical breath, was measured in 19 patients undergoing laparoscopic cholecystectomy. We developed a system to perform SPV measurement on demand using a tonometric sensor on the radial artery and a personal computer. We compared SPV before pneumoperitoneum with that after pneumoperitoneum (insufflation pressure 8∼10mmHg) in the horizontal position (9 patients) and with the head tilted up (10 patients). In the horizontal position, the delta Down component of the SPV significantly decreased and the delta Up component of the SPV significantly increased. These changes in the two components suggest increases in venous return and instroke volume due to pneumoperitoneum. With the head tilted up, however, the two components of SPV did not change. These findings suggest that increases in venous return following pneumoperitoneum are attenuated by having the head tilted up. SPV measurement provides important information about the shift of intravascular blood volume caused by pneumoper-itoneum in patients during laparoscopic cholecystectomy.
- 日本臨床麻酔学会の論文
日本臨床麻酔学会 | 論文
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