Hemodynamic effects of laparoscopic radiofrequency ablation of liver tumors versus laparoscopic hepatic ultrasound examination

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• 作者：Mordechai Shimonov ; MD^a ; ^b (Lecturer ; Head) ; Michael Protianov ; MD^b ; ^c (Attending Anesthesiologist) ; Michael Blecher ; MD^a ; ^b (Attending Surgeon) ; Pinhas Schachter ; MD^a ; ^b (Associate Professor) ; Ofer Landau ; MD^b ; ^d (Lecturer) ; Tiberiu Ezri ; MD^b ; ^c ; ^e ; ^{tezri@bezeqint.net} (Associate Professor ; Head)
• 关键词：Hemodynamic effects ; Laparoscopic hepatic ultrasound examination ; Laparoscopic radiofrequency ablation ; Liver tumors
• 刊名：Journal of Clinical Anesthesia
• 出版年：2012
• 期刊代码：147_09528180
• 类别：med
• 出版时间：March, 2012
• 卷：24
• 期：2
• 页码：96-100
• 文件大小：120 K

摘要

Study Objective

To compare the hemodynamic changes that occur during laparoscopic radiofrequency ablation of liver metastases with those occurring during laparoscopic ultrasound hepatic examination alone.

Design

Prospective, observational study.

Setting

Operating rooms of a university-affiliated hospital.

Patients

40 ASA physical status 2 and 3 patients with liver metastases.

Interventions

20 patients underwent laparoscopic radiofrequency ablation of liver tumors following laparoscopic ultrasound examination, and 20 had laparoscopic ultrasound examination alone. The anesthetic technique was standardized.

Measurements

The primary endpoint of the study was the number of episodes of mean arterial pressure (MAP) < 70 mmHg. Secondary endpoints were significant differences between the groups in MAP, heart rate, cardiac index, ejection fraction (EF; both measured with thoracic bioimpedance), calculated systemic vascular resistance index (SVRI), and central venous pressure.

Main Results

The number of episodes of MAP < 70 mmHg did not differ between groups: there were 9 episodes in the ultrasound alone group and 7 in the radiofrequency group (P = 0.668). Cardiac index, EF, and SVRI were similar between groups. Central venous pressure was slightly higher in the radiofrequency group [11.99 (10.8-13.2) mmHg vs. 10.3 (9.2-11.4) mmHg, P = 0.04].

Conclusions

Hemodynamic profiles were similar when comparing laparoscopic radiofrequency ablation of liver metastases with laparoscopic ultrasound hepatic examination alone.