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Elective Intraoperative Intracranial Pressure Monitoring During Laparoscopic Cholecystectomy

Elective Intraoperative Intracranial Pressure Monitoring During Laparoscopic Cholecystectomy Abstract The effects of artificial pneumoperitoneum on intracranial pressure have not been clearly defined. Initial animal studies indicate that elevated intra-abdominal pressure might have a deleterious effect on intracranial pressure. We report a case in which intracranial pressure was monitored intraoperatively during laparoscopic cholecystectomy. Intracranial pressure increased abruptly when the peritoneal cavity was insufflated, with the operating table in the Trendelenburg position, and decreased slightly with elevation of the head of the operating table. Initial opening intracranial pressure values were re-established on desufflation of the abdomen. Intracranial pressure monitoring should be considered when planning a laparoscopic procedure on patients with the potential for decreased intracranial compliance. (Arch Surg. 1995;130:1011-1013) References 1. NIH Consensus Development Panel on Gallstones and Laparoscopic Cholecystectomy. Gallstones and laparoscopic cholecystectomy . JAMA . 1993;269:1018-1024.Crossref 2. Westerband A, Van De Water J, Amzallag M, et al. Cardiovascular changes during laparoscopic cholecystectomy . Surg Gynecol Obstet . 1992;175:535-538. 3. Goodale RL, Beebe DS, McNevin MP, et al. Hemodynamic, respiratory, and metabolic effects of laparoscopic cholecystectomy . Am J Surg . 1993;166:533-537.Crossref 4. Ho HS, Gunther RA, Wolfe BM. Intraperitoneal carbon dioxide insufflation and cardiopulmonary functions . Arch Surg . 1992;127:928-933.Crossref 5. Baxter JN, O'Dwyer PJ. Pathophysiology of laparoscopy . BrJ Surg . 1995;82:1-2.Crossref 6. Josephs LG, Este-McDonald JR, Birkett DH, Hirsch EF. Diagnostic laparoscopy increases intracranial pressure . J Trauma . 1994;36:815-819.Crossref 7. Shapiro HM. Intracranial hypertension . Anesthesiology . 1975;43:445-471.Crossref 8. Shapiro HM, Marshall LF. Intracranial pressure responses to PEEP in headinjured patients . J Trauma . 1978;18:254-256.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Elective Intraoperative Intracranial Pressure Monitoring During Laparoscopic Cholecystectomy

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Publisher
American Medical Association
Copyright
Copyright © 1995 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1995.01430090097028
Publisher site
See Article on Publisher Site

Abstract

Abstract The effects of artificial pneumoperitoneum on intracranial pressure have not been clearly defined. Initial animal studies indicate that elevated intra-abdominal pressure might have a deleterious effect on intracranial pressure. We report a case in which intracranial pressure was monitored intraoperatively during laparoscopic cholecystectomy. Intracranial pressure increased abruptly when the peritoneal cavity was insufflated, with the operating table in the Trendelenburg position, and decreased slightly with elevation of the head of the operating table. Initial opening intracranial pressure values were re-established on desufflation of the abdomen. Intracranial pressure monitoring should be considered when planning a laparoscopic procedure on patients with the potential for decreased intracranial compliance. (Arch Surg. 1995;130:1011-1013) References 1. NIH Consensus Development Panel on Gallstones and Laparoscopic Cholecystectomy. Gallstones and laparoscopic cholecystectomy . JAMA . 1993;269:1018-1024.Crossref 2. Westerband A, Van De Water J, Amzallag M, et al. Cardiovascular changes during laparoscopic cholecystectomy . Surg Gynecol Obstet . 1992;175:535-538. 3. Goodale RL, Beebe DS, McNevin MP, et al. Hemodynamic, respiratory, and metabolic effects of laparoscopic cholecystectomy . Am J Surg . 1993;166:533-537.Crossref 4. Ho HS, Gunther RA, Wolfe BM. Intraperitoneal carbon dioxide insufflation and cardiopulmonary functions . Arch Surg . 1992;127:928-933.Crossref 5. Baxter JN, O'Dwyer PJ. Pathophysiology of laparoscopy . BrJ Surg . 1995;82:1-2.Crossref 6. Josephs LG, Este-McDonald JR, Birkett DH, Hirsch EF. Diagnostic laparoscopy increases intracranial pressure . J Trauma . 1994;36:815-819.Crossref 7. Shapiro HM. Intracranial hypertension . Anesthesiology . 1975;43:445-471.Crossref 8. Shapiro HM, Marshall LF. Intracranial pressure responses to PEEP in headinjured patients . J Trauma . 1978;18:254-256.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Sep 1, 1995

References