Journal of Yeungnam Medical Science

Original Articles

Attenuation of pneumoperitoneum-induced hypertension by intra-peritoneal lidocaine before pneumoperitoneum in laparoscopic cholecystectomy.: Sun Ok Song, Hae Mi Lee, Sung Soo Yun, Hwarim Yu, Soo Young Shim, Heung Dae Kim; Yeungnam Univ J Med. 2016;33(2):90-97. Published online December 31, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.2.90

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Abstract PDF: BACKGROUND
We have previously found that intra-peritoneal lidocaine instillation before pneumoperitoneum attenuates pneumoperitoneum-induced hypertension. Whether this procedure alters patient's hemodynamic status during operation should be determined for clinical application. This study elucidated the possible mechanism of the attenuation of the pneumoperitoneum-induced hypertension by intra-peritoneal lidocaine before pneumoperitoneum. METHODS: Thirty-four patients underwent laparoscopic cholecystectomy (LC) were randomly allocated into two groups. After induction of general anesthesia, 200 mL of 0.2% lidocaine (lidocaine group, n=17), or normal saline (control group, n=17) were sub-diaphragmatically instilled 10 minutes before pneumoperitoneum. The changes in systolic blood pressure, heart rate, central venous pressure, stroke volume, cardiac output, and systemic vascular resistance were compared between the groups. The number of analgesics used during post-operative 24 h was compared. RESULTS: Systolic blood pressure was elevated during pneumoperitoneum in both groups (p<0.01), but the degree of elevation was significantly reduced in the lidocaine group than in the control (p<0.01). However, stroke volume and cardiac output were decreased and systemic vascular resistance was increased after induction of pneumoperitoneum (p<0.05) without statistical difference between two groups. The number of analgesics used was significantly reduced in the lidocaine group (p<0.01). CONCLUSION: These data suggest that intra-peritoneal lidocaine before pneumoperitoneum does not alter patient's hemodynamics, and attenuation of pneumoperitoneum-induced hypertension may be the consequence of reduced intra-abdominal pain rather than the decrease of cardiac output during pneumoperitoneum. Therefore, intra-peritoneal lidocaine instillation before pneumoperitoneum is a useful method to manage an intraoperative pneumoperitoneum-induced hypertension and to control postoperative pain without severe detrimental hemodynamic effects.

Cardiovascular Effects of Free Movement of Abdominal Muscle in Prone Positioning during General Anesthesia.: Ji Yoon Kim, Dong Won Lee, Il Sook Seo, Sae Yeon Kim; Yeungnam Univ J Med. 2007;24(2):206-215. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2.206

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BACKGROUND
The prone position is often used for operations involving the spine and provides excellent surgical access. The complications associated with the prone position include ocular and auricular injuries, and musculoskeletal injuries. In particular, the prone position during general anesthesia causes hemodynamic changes. To evaluate the cardiovascular effects of the prone position in surgical patients during general anesthesia, we investigated the effects on hemodynamic change of the prone position with the Jackson spinal surgery table. MATERIALS AND METHODS:Thirty patients undergoing spine surgery in the prone position were randomly selected. After induction of general anesthesia, intra-arterial and central venous pressures (CVP) were monitored and cardiac output was measured by NICO(R). We measured stroke volume, cardiac index, cardiac output, mean arterial pressure, heart rate, CVP and systemic vascular resistance (SVR) before changing the position. The same measurements were performed after changing to the prone position with the patient on the Jackson spinal surgery table. RESULTS: In the prone position, there was a significant reduction in stroke volume, cardiac index and cardiac output. The heart rate, mean arterial pressure and CVP were also decreased in the prone position but not significantly. However, the SVR was increased significantly. CONCLUSION: The degree of a reduced cardiac index was less on the Jackson spinal surgery table than other conditions of the prone position. The reduced epidural pressure caused by free abdominal movement may decrease intraoperative blood loss. Therefore, the Jackson spinal surgery table provides a convenient and stable method for maintaining patients in the prone position during spinal surgery.

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Comparison of the Level and Side Effects of Spinal Anesthesia with Hyperbaric Bupivacaine in the Supine, Lateral, and Prone Positions
Ji Young Moon, Bo Hwan Kim
Journal of Korean Biological Nursing Science.2015; 17(2): 114. CrossRef

The Effects of Preoperative Sprayed 10% Lidocaine on the Hemodynamic Response during Suspension Microlaryngeal Surgery.: Deok Hee Lee, Hyun Seok Do; Yeungnam Univ J Med. 2007;24(2):162-169. Published online December 31, 2007; DOI: https://doi.org/10.12701/yujm.2007.24.2.162

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Abstract PDF: PURPOSE: It is well known that suspension microlaryngeal surgery produces marked increases in arterial blood pressure and heart rate. In this study, we evaluated the effects of 10% lidocaine preoperatively sprayed for attenuation of the perioperative hemodynamic response during suspension microlaryngeal surgery. MATERIALS AND METHODS: Fifty American Society of Anesthesiologists (ASA) class 1 patients scheduled for excision of a vocal polyp by suspension laryngoscopy were randomly divided into two groups (n=25 for each group). They were intubated without 10% lidocaine spray (control group) or given 1.5 mg/kg of 10% lidocaine sprayed onto the pharyngolaryngeal and intratracheal sites 90 sec prior to intubation (10% lidocaine group). Anesthesia was maintained using desflurane in O2/N2O 50%. The arterial blood pressure and heart rate were measured at preinduction (T0), 1 min (T1), 3 min (T2), 5 min (T3) after tracheal intubation, and 1 min (T4), 3 min (T5), 5 min (T6) and 10 min (T7) after the suspension laryngoscopy. RESULTS: In the 10% lidocaine group, the arterial blood pressure and heart rate at 1 (T1), 3 (T2) min after tracheal intubation and 1 (T4), and 3 (T5) min after suspension laryngoscopy were lower than the same measurements in the control group. CONCLUSION: 10% lidocaine sprayed onto the pharyngolaryngeal and intratracheal sites before intubation was an effective method for attenuation of the perioperative hemodynamic response during suspension microlaryngeal surgery.

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