HEMODYNAMIC AND RESPIRATORY EFFECTS OF PNEUMOPERITONEUM AND PEEP DURING LAPAROSCOPIC PELVIC LYMPHADENECTOMY IN DOGS

Extended laparoscopic operations are being performed increasingly in h igh-risk patients. To assess the effects of increased intraabdominal p ressure (IAP) and positive end-expiratory pressure (PEEP) on the hemod ynamic and respiratory system during extended procedures a carbon diox ide pneumoperitoneum was artificially induced in 10 dogs undergoing la paroscopic pelvic lymphadenectomy. An increase in IAP up to 15 mmHg ha d no negative effect on the cardiovascular system. However, the combin ation of an increased IAP (10-15 mmHg) with PEEP (8 cmH2O) markedly de pressed the hemodynamic variables. Measurement of arterial carbon diox ide and fractional end-tidal carbon dioxide revealed significant CO2 r etention. We conclude from the results that laparoscopic pelvic lympha denectomy should be performed in high-risk patients only under general anesthesia with expanded cardiopulmonary monitoring.