Impact of pneumoperitoneum pressure on cardiac output in laparoscopic surgery.

Objective: To assess the impact of pneumoperitoneum pressure on cardiac output (CO) in patients undergoing laparoscopic surgery using transesophageal echocardiography.

Methods: Fifty patients (26 men, 24 women; age, 55-85 years old) who scheduled for laparoscopic colorectal cancer resection under general anesthesia at the First People's Hospital of Taicang (March 2021-December 2022) were enrolled. Patients were randomly assigned to three groups based on pneumoperitoneum pressure: group A (10 mmHg), group B (12 mmHg), and group C (14 mmHg). Left ventricular outflow tract diameter (LVOT) and velocity time integral (VTI) were measured using transesophageal echocardiography to calculate CO).

Results: Baseline characteristics and intraoperative data were comparable among groups (P > 0.05). Post-anesthesia, heart rate, mean arterial pressure (MAP), systolic blood pressure (SBP), and diastolic blood pressure (DBP) showed no significant differences among groups (P > 0.05). However, CO in all groups was lower than normal reference values after anesthesia induction (P < 0.05) and further declined following pneumoperitoneum establishment (P < 0.05). Group C exhibited significantly lower CO than Groups A and B five minutes after pneumoperitoneum initiation (P < 0.05).

Conclusion: Pneumoperitoneum pressure significantly impacts CO during laparoscopic surgery. Transesophageal echocardiography provides an effective method for monitoring hemodynamic changes and optimizing perioperative management.