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The aim of this study was to compare the hemodynamic and ventilatory effects of prolonged infrarenal aortic cross-clamping in pigs undergoing either laparotomy or laparoscopy.  18 pigs were used for this study.  Infrarenal aortic crossclamping was performed for 60 minutes in groups I (laparotomy,  n  = 6) and II (laparoscopy,  n  = 6). Group III (laparoscopy,  n  = 6) underwent a 120-minute long pneumoperitoneum in absence of aortic clamping (sham group). Ventilatory and hemodynamic parameters and renal function were serially determined in all groups.  A significant decrease in pH and significant increase in PaCO 2  were observed in group II, whereas no changes in these parameters were seen in group I and III. All variables returned to values similar to baseline in groups I and II 60 minutes after declamping. A significant increase in renal resistive index was evidenced during laparoscopy, with significantly higher values seen in Group II.  Thus a synergic effect of pneumoperitoneum and aortic cross-clamping was seen in this study. These two factors together cause decreased renal perfusion and acidosis, thus negatively affecting the patient's general state during this type of surgery.

anesthesiology research and practice

Physiologic Responses to Infrarenal Aortic Cross-Clamping during Laparoscopic or Conventional Vascular Surgery in Experimental Animal Model: Comparative Study