Effects Of Artificial Intra-abdominal Hypertension On Stroke Volume Variation In Patients Undergoing Laparoscopic Surgery

Objective:To investigate the influence of artificial intra-abdominal hypertension(IAH)on stroke volume variation(SVV)in patients undergoing laparoscopic surgery.Methods:Thirty patients scheduled to undergo laparoscopic operation for benign ovarian tumor resection were enrolled in the Second Hospital of Shandong University from2010March to2010May, aged18to60years, ASA Ⅰ or Ⅱ. All patients had general anesthesia with volume control ventilation, tidal volume (VT)8ml/kg, respiratory rate (RR)12times/min. Airway pressure, bispectral index (BIS), central venous pressure (CVP) and stroke volume variation(SVV) were measured at five time points:5min after induction(T0),5min after volume expansion with6%hydroxyethyl starch130/0.4of7mL/kg(T1),5min after12mmHg artificial IAH were established(T2),30min after the beginning of the operation (T3),5min after the ending of the operation(T4).Results:Airway pressure were significantly increased during IAH (P＜0.01), and dropped back to normal level after IAH. CVP increased after volume expansion(T1compared with T0, P＜0.05),significantly increased during IAH (T2、 T3compared with T1, P＜0.01),and decreased after IAH (T4compared with T2/T3, P＜0.01), but still higher than the base line (T4compared with T1, P＜0.05).SVV significantly decreased after volume expansion (T1compared with T0o, P＜0.01) decreased after IAH (T2、T3compared with T1, P＜0.01) and back to the baseline after the IAH.Conclusion:SVV is more sensitive and more accurate than CVP when used to evaluate the volume status and fluid therapy response of patients. But IAH decreases the value of SVV, this makes deviations when SVV is used in patients undergoing laparoscopic surgery.