The effects of body weight and pneumoperitoneum on Pleth Variability
Index and Total Hemoglobin in patients undergoing laparoscopic
cholecystectomy: a prospective observational study.
Abstract Background It is not clear if there is a inaccurate effect of
obesity and pneumoperitoneum on non-invasive monitoring parameters
Objectives To determine the effects of CO2 pneumoperitoneum and
desufflation on non-invasive monitoring variables between obese and
non-obese patients undergoing laparoscopic surgery. Methods Sixty
patients were included in the study who underwent laparoscopic
cholecystectomy between February 2019-November 2019. After anesthesia
induction, systolic and diastolic blood pressures, heart rate(HR),
operation and pneumoperitoneum durations, PVI and SpHg data were
recorded. Results The patients were divided into two groups. There was
no statistically significant difference between the groups in terms of
chronic diseases, operation and pneumoperitoneum durations.
Statistically no significant difference was found between the groups for
PVI and SpHb values. In comparison of PVI measurement values according
to T0, a significant difference was found in T3,T4 and T5 in Group 2
compared to T0 (p=0.010;0.012;0.041). In comparison of SpHb measurement
values according to T0, a statistically significant difference was found
in T1,T2 and T3 in Group 2 compared to T0 (p=0.008;0.010;0.037). In
comparison to T5, there was a significant difference in T1,T2 and T3 in
Group 2 (p=0.023;0.005;0.006). Conclusion In obese people,
pneumoperitonium can lead to inaccuracies in monitoring PVI and SpHb.
Although these two parameters are very valuable in intraoperative
follow-up, they should be used carefully during laparoscopic procedures
in obese patients. If these parameters (PVI and SpHb) are considered to
be used in bariatric surgeries, this information should be considered.