Effect Of Pneumoperitoneum On Svv In Elderly Patients Undergoing Laparoscopic Gastrointestinal Cancer

Objective:To observe the changes of perioperative variability(SVV)in patients with gastrointestinal neoplasms with laparoscopic cholecystectomy,and to study the effect of pneumoperitoneum on SVV in elderly patients with gastrointestinal cancer.Methods:30 patients with general anesthesia who underwent radical mastectomy were selected.The age was ≥65 years old,ASA Ⅱ～Ⅲ level,the tidal volume was 10ml/kg,the respiratory rate was 10-12 times/min(adjusted according to PETC02).(ECG),blood pressure(BP),heart rate(HR),pulse oxygen saturation(SP02),bispectral index(BIS)The radial artery was punctured and connected to Vigileo device.(P<0.05).After the induction of anesthesia,the hemodynamics were measured at 5 min after 5 minutes of baseline(pre-pneumoperitoneum)as T1,artificial pneumoperitoneum(pressure 11 mmHg)for 5 min(after pneumoperitoneum)Recorded as T2,post-ventral posterior low after 5min as T3,5min before deflation as T4,5min after deflation as T5,deflation to supine position after 5min as T6.Recorded six points of MAP,HR,CVP,CI,SVI,SVV,Pmax.Results:Compared with pre-pneumoperitoneum(T1),SVV was significantly increased at 5 min(T2)after C02 pneumoperitoneum,SVI and CI were observably lower than those before pneumoperitoneum,CVP,MAP and airway peak pressure(Pmax)(P<0.05).The levels of MAP,HR,CVP and Pmax were significantly increased(P<0.05),SVV,CI(P<0.05)at 5 min(T3)(P<0.05),and the changes of SVV,MAP,CVP and Pmax were significantly decreased at 5min(T5),and CI and SVI were significantly increased(P<0.05)at 5min(T4)(P<0.05).The MAP,CVP and Pmax were significantly decreased at 5 min after supine position(P<0.05).Conclusion:Laparoscopic gastrointestinal cancer surgery(in the pneumoperitoneum pressure of 11mmHg),pneumoperitoneum on older patients with SVV have a significant impact,SVV threshold may change.