Evaluation of systemic circulation at laparoscopic surgery for ectopic pregnancy

Aim. To study the effect of tension carboxyperitoneum on central circulatory parameters of patients undergoing laparoscopy.

Methods. Vascular wall condition, linear blood flow velocity, pulse wave velocity, vascular wall rigidity, general and specific peripheral resistance (by the method of volumetric compression oscillometry) were evaluated. The study included patients with tubal pregnancy undergoing endovideosurgery. In the first group, 76 patients, the operation was performed without introducing carbon dioxide into the abdominal cavity; operational volume has been created using the original retractor of the anterior abdominal wall. In the second group (67 patients), classical technique of laparoscopic surgery with the use of carboxyperitoneum was applied. Measurements of systemic circulatory parameters were performed in patients twice - in the group where no gas was used - before and 15 minutes after introducing laparoscopic devices, in the group of carboxyperitoneum - before and 15 minutes after carbon dioxide introduction.

Results. The changes of systemic circulatory parameters were non-significant in patients of the first group and did not lead to statistically significant changes of mean, lateral and systolic blood pressure. Endovideosurgery using carboxyperitoneum lead to systemic circulatory disorders: blood pressure instability, increased cardiac output and index, decreased total peripheral vascular resistance, and the actual and specific peripheral resistance, as well as linear flow velocity and vascular rigidity.

Conclusion. Laparoscopic surgery using carbon dioxide are associated with the vessel compression and increased heart load, clinically manifesting as blood pressure disorders.