Cardiovascular autonomic function in patients with hemodynamic instability at induction of capnoperitoneum: a case-control study

A Alijani, G B Hanna, M Band, A D Struthers, A Cuschieri

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    5 Citations (Scopus)

    Abstract

    Background: This study hypothesized that patients in
    whom bradycardia and hypotension develop with induction
    of positive-pressure capnoperitoneum have an
    underlying autonomic cardiovascular dysfunction.
    Methods: A case–control study was conducted to examine
    the baseline autonomic function of patients in
    whom bradycardia and hypotension develop with induction
    of positive-pressure capnoperitoneum. The
    control group consisted of patients who maintained
    normal cardiac rhythm and blood pressure during the
    same procedure. Two groups of tests were performed:
    bedside stress tests of cardiovascular autonomic function
    (response graded 1 (normal) to 4 (severely abnormal)
    and heart rate variability analysis (spectral and
    time domain components).
    Results: The study evaluated 6 patients in the bradycardia
    group and 10 in the control group. The group in
    whom bradycardia had developed scored significantly
    worse on the bedside stress tests than the control group
    (for grades I to IV: v2 = 6.5, p = 0.022; for trend:
    v2 = 5.6, p = 0.018). In contrast, both groups had
    similar baseline autonomic tone, as measured by heart
    rate variability.
    Conclusions: Patients in whom bradycardia and hypotension
    develop with induction of positive-pressure
    capnoperitoneum have cardiovascular autonomic dysfunction,
    which is identifiable by bedside stress tests of
    autonomic function.
    Original languageEnglish
    Pages (from-to)915-8
    Number of pages4
    JournalSurgical Endoscopy
    Volume18
    Issue number6
    DOIs
    Publication statusPublished - 2004

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