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Background and Aims: During laparoscopic procedures, hemodynamic stability is of great concern. Thisstudy was carried out to evaluate hemodynamic Changes with different intra- abdominal pressure (IAP) forlaparoscopic cholecystectomy using Advanced Cardiac Output (FloTrac) Monitoring.Materials and Methods: In this Prospective, randomized and observational study, total 90 patients ASAgrade I, II scheduled for laparoscopic cholecystectomy were randomly allocated to three groups: GroupI :10-12mm hg, groupII-13-15mmhg, Group III- > 15mmhg. Central venous line and arterial cannulawas secured before induction and connected to FloTrac monitor. Heart rate (HR), Cardiac index (CI),Systemic vascular resistance index (SVRI), Stroke volume variation (SVV), Oxygen saturation (SPO2)were monitored at various interval. For Statistical analysis student t-test and ANOVA test were used.Results: At all time intervals, HR of Group I was found to be lower than Group II and Group III exceptat insufflation. CI (Cardiac Index) of Group I was also found to be lower than that of Group II and that ofGroup III was lower than that of Group II at all time intervals. At all time periods values of SVRI, SVV ofGroup I were found to be lower than that of Group II and Group III. SVRI, SVV of Group II were found tobe lower than that of Group III.Conclusions: IAP value above 15mm Hg seems to affect the hemodynamics significantly. Study showedthat the IAP rise from 10-12 to 13-15 does not influence hemodynamics significantly, and could be adjudgedrelatively safe.Keywords: Intra-abdominal pressure, Laparoscopic cholecystectomy, Hemodynamic paramaters, Cardiac index, Systemic vascular resistance index, Stroke volume variation flow-trac.

indian journal of clinical anaesthesia

Evaluation of hemodynamic changes with different abdominal pressure for laproscopic cholecystectomy using advanced cardiac output (Flo-Trac) monitoring