Page 10 - Peer Reviewed Laparoscopic Jornal

Swapan Kumar Maiti et al

Fig. 7: Mean ± SE of plasma alanine aminotransferase (U/L) Fig. 8: Mean + SE of plasma cortisol (mmol/l) recorded in the
recorded in the animals of three different groups animals of three different groups

16 animals during laparoscopic examination. The low post-CP periods was in tune with the observation of decrease
insufflations pressure of CO might attribute to insufficient in heart rate and might be as a result of hypercarbia following
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spacing and separation of the abdominal structures from CP. 16,17 Wandering pacemakers, and atrial premature
the ventral abdominal wall and led to these complications. complexes were occasionally seen in this study. Wandering
Visualization of the abdominal organs started from the pacemaker a variant of sinus arrhythmia is a shift of
urinary bladder which was readily and promptly visualized pacemaker within the SA node and observed even in normal
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by its unique tortuous vasculature over the visceral surface. dogs. Atrial premature complexes, AV junction premature
Identification and visualization of various internal organs complexes, wandering pacemaker and intermittent sinus
like liver, spleen and pancreas, kidney, ovary and uterus arrest seems to a normal variants and might be due to an
during various laparoscopic surgeries have been increase in vegal tone in individual dogs on CP. The increase
reported. 10,11 Evaluation of laparoscopic organ visualization in amplitude of T-wave was more marked in group C at
at different CO pressure gradient revealed marked 60 minutes post-CP, and could be related to the transient
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differences among the three groups. Urinary bladder was hyperkalemia owing to CP. Biphasic T-wave and T-wave
visualized distinctly in all the animals of all three groups alternant were more marked in animals of group C. Large
without any significant difference. But visualization of liver T-wave possibly indicated hyperkalemia and ST depression
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in group C differed significantly from group A. In groups suggested myocardial ischemia. The ST intervals did not
B and C significantly better visualization was observed than reveal any significant changes throughout the observation
that was in group A when other organs were evaluated. in three groups, however, ST elevation (in group A) and ST
depression (in group C) were observed in some animals
No significant differences were found between the during post-CP and were suggestive of myocardial ischemia
various groups as related to the physiologic parameters as a result of CP during laparoscopy. 20
except the respiration rate. Following CP, it was increased PCV and Hb were unchanged throughout the observation
in all groups, but it was significant in group C at 60 minutes period in all groups and remained within the normal range
after CP. Soon after CO insufflation, CO absorbed from as also reported by Delling et al 24 hours after laparoscopy.
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abdominal cavity led to hypercapnia and hypercarbia which The mean value of TLC revealed a nonsignificant increase
might stimulate the respiratory center and as compensation at 60 and 120 minutes after CP in group C might be due to
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respiration rate was increased. CP is associated with an the effect of corticosteroid, released as a stress response of
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increase in plasma potassium concentration, metabolic increased IP at higher CO pressure gradient of group C. In
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acidosis and hemodynamic changes; therefore, this study, significant decrease of pH value was observed
concomitant changes in electrocardiogram can be logically at 120 minutes after CP in group C might be due to
speculated. Although the initial heart rate ranged widely hypercapnia developed as a result of increased absorption
among the animals of three groups, it markedly decreased of CO in blood from peritoneal cavity. Significant increase
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during post-CP period, which could be attributed to of pCO in post-CP period in all the three groups might be
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parasympathetic effect on vagus nerve owing to increased due to compensate the respiratory acidosis developed as a
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intra-abdominal pressure. Increase in R-R interval during result of hypercarbia.
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