The Effects of Body Weight and Pneumoperitoneum on Pleth Variability Index and Total Haemoglobin in Patients Undergoing Laparoscopic Cholecystectomy: a Prospective Observational Study

Abstract

Objective: It is not clear if there is an inaccurate effect of obesity and pneumoperitoneum on non-invasive monitoring parameters.The aim of this study is to determine the effects of CO2 pneumoperitoneum and desufflation on non-invasive monitoring variables between obese and non-obese patients undergoing laparoscopic surgery. Material and Methods: Sixty patients were included in the study that underwent laparoscopic cholecystectomy between February 2019 and November 2019. After induction of anaesthesia, systolic and diastolic blood pressures, heart rate, duration of operation and pneumoperitoneum, pleth variability index (PVI) and total haemoglobin (SpHb) data were recorded. Results: The patients were divided into two groups. There was no significant difference between the groups in terms of chronic diseases and duration of operation and pneumoperitoneum. No significant difference was found between the groups in PVI and SpHb values. In comparison of PVI measurement values with T0, a significant difference was found in T3, T4 and T5 in Group 2 (p = 0.010, 0.012 and 0.041, respectively). In comparison of SpHb measurement values with T0, a significant difference was found in T1, T2 and T3 in Group 2 (p = 0.008, 0.010 and 0.037, respectively). In comparison with T5, a significant difference was found in T1, T2 and T3 in Group 2 (p = 0.023, 0.005 and 0.006, respectively). Conclusion: In obese people, pneumoperitoneum can lead to errors in PVI and SpHb monitoring. 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.

Keywords

• laparoscopic cholecyctectomy
• pneumoperitoneum
• Pleth variability index
• total haemoglobin

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