Journal of laparoendoscopic & advanced surgical techniques. Part A
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J Laparoendosc Adv Surg Tech A · May 2012
Randomized Controlled Trial Comparative StudyComparison of the stress response in patients undergoing gynecological laparoscopic surgery using carbon dioxide pneumoperitoneum or abdominal wall-lifting methods.
Conventional laparoscopy is aided by CO(2) insufflation, but this may impair cardiorespiratory function, induce stress responses, and result in life-threatening complications. CO(2) insufflation is usually conducted under general anesthesia, whereas gasless laparoscopy supposedly eliminates most of these disadvantages. In this study, we compared the changes of concentration of serum cortisol, tumor necrosis factor alpha (TNF-alpha), interleukin (IL)-6, IL-10, and heat shock protein 70 (Hsp70) in patients undergoing gynecological laparoscopic surgery in order to explore the severity of the stress response following CO(2) pneumoperitoneum or abdominal wall-lifting methods combined with the different anesthetic techniques performed. ⋯ Gynecological laparoscopic surgery using abdominal wall-lifting methods could avoid the deleterious effects of CO(2) pneumoperitoneum, and reduce the stress response. The lowest stress response was found when abdominal wall-lifting methods were used with the patient under epidural anesthesia.