Prospective comparison of cardiopulmonary events during minilaparoscopy and colonoscopy under conscious sedation

• Published in: Endoscopy Vol. 37; no. 5; p. 460
• Main Authors: Denzer, U, Mollenhauer, M, Kanzler, S, Galle, P R, Lohse, A W
• Format: Journal Article
• Language: English
• Published: Germany 01.05.2005
• Subjects: Blood Pressure - physiology; Colonoscopy; Conscious Sedation; Electrocardiography; Heart - physiopathology; Heart Rate - physiology; Humans; Laparoscopy; Lung - physiopathology; Monitoring, Intraoperative; Oximetry; Prospective Studies
• ISSN: 0013-726X; 1438-8812
• DOI: 10.1055/s-2005-861195

Cardiorespiratory parameters were examined throughout diagnostic minilaparoscopy procedures. The same parameters were analyzed during colonoscopy, and the data were compared. Sixty-five consecutive unselected patients undergoing minilaparoscopy (group 1: ASA I, n = 34; group 2: ASA II/III, n = 31) and 61 consecutive unselected patients undergoing colonoscopy (group 3: ASA I, n = 31; group 4: ASA II/III, n = 30) were included. Oxygen saturation (Sao (2)), heart rate (HR) and mean arterial pressure (RRm) were measured continuously, and 12-lead electrocardiography (ECG) recordings were made at specific times during each procedure. Minor differences were observed, particularly after premedication, probably due to different dosage regimens and timing in the two examination techniques. After premedication, testing for differences from baseline values showed a minor decrease in Sao (2) and RRm in the minilaparoscopy groups in comparison with the colonoscopy groups (median Sao (2), group 1: 99.9 % +/- 0 vs. group 3 : 100 % -1, P = 0.0078; median RRm, group 1: 99.5 - 4 mm Hg vs. group 3 : 96 -16 mm Hg, P = 0.046, and median RRm, group 2 : 110 + 1 mm Hg vs. group 4 : 101 -13.5 mm Hg, P = 0.0007). HR increased in minilaparoscopy in comparison with colonoscopy (median HR: group 2 : 77 + 4 beats/min vs. group 4 : 75.5 +/- 0 beats/min; P = 0.01). Comparison of defined relevant pathological changes in Sao (2), RRm, HR, and ECG showed no significant differences. These data indicate that diagnostic minilaparoscopy under conscious sedation is only associated with limited risk in patients with compensated cardiopulmonary diseases. This is probably due to the low insufflation pressure used.