Influence of pneumoperitoneum and head-down maneuver on the cerebral microvasculature in rabbits
Abstract Background With recent advances in robot-assisted techniques, an increasing number of surgeries are being performed with pneumoperitoneum and head-down maneuver (HDM) that may affect the cerebral microcirculation. For the first time, this study investigated the direct influence of pneumoper...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2022-12-01
|
| Series: | BMC Anesthesiology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12871-022-01911-2 |
| _version_ | 1811190340948852736 |
|---|---|
| author | Hiroki Kobayashi Nobumasa Asano Daisuke Kondo Noriyuki Shintani Masakazu Kotoda Toru Matsuoka Tadahiko Ishiyama Takashi Matsukawa |
| author_facet | Hiroki Kobayashi Nobumasa Asano Daisuke Kondo Noriyuki Shintani Masakazu Kotoda Toru Matsuoka Tadahiko Ishiyama Takashi Matsukawa |
| author_sort | Hiroki Kobayashi |
| collection | DOAJ |
| description | Abstract Background With recent advances in robot-assisted techniques, an increasing number of surgeries are being performed with pneumoperitoneum and head-down maneuver (HDM) that may affect the cerebral microcirculation. For the first time, this study investigated the direct influence of pneumoperitoneum and HDM on the cerebral microvasculature in rabbits. Methods Adult male rabbits were randomly allocated to the following groups (n = 7 each): control, pneumoperitoneum alone (P), and pneumoperitoneum with HDM (P + HDM) for 120 min. A closed cranial window was installed above the parietal bone to visualize the pial microvasculature. Pial arteriolar diameter and hemodynamic and blood gas parameters were measured during the 140-min observation period. Brain edema was assessed by evaluation of the brain water content at the end of the experiment. Results Rabbits in the P and P + HDM groups exhibited a similar degree of immediate pial arteriolar dilation following the initiation of both P and P + HDM (P: 1.11 ± 0.03, p = 0.0044 and P + HDM: 1.07 ± 0.02, p = 0.0004, relative changes from the baseline value by defining the baseline as one). In the P + HDM group, pial arteriole diameter returned to the baseline level following the discontinuation of pneumoperitoneum and HDM (1.05 ± 0.03, p = 0.0906, vs. baseline). In contrast, the pial arterioles remained dilated as compared to the baseline level in the P group after discontinuation of pneumoperitoneum. There were no changes in pial arteriole diameter in the animals in the control group. Heart rate, blood gas parameters, and brain water content were not significantly different between the groups. Conclusion The pial arterioles dilated immediately after pneumoperitoneum with or without HDM. The pial arterioles remained dilated 20 min after discontinuation of pneumoperitoneum alone but constricted upon discontinuation of pneumoperitoneum plus HDM. Pneumoperitoneum and HDM for 2 h did not cause brain edema. |
| first_indexed | 2024-04-11T14:49:39Z |
| format | Article |
| id | doaj.art-bdf7e75bd34b496fb071a1b779ba5ec1 |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-04-11T14:49:39Z |
| publishDate | 2022-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-bdf7e75bd34b496fb071a1b779ba5ec12022-12-22T04:17:32ZengBMCBMC Anesthesiology1471-22532022-12-012211710.1186/s12871-022-01911-2Influence of pneumoperitoneum and head-down maneuver on the cerebral microvasculature in rabbitsHiroki Kobayashi0Nobumasa Asano1Daisuke Kondo2Noriyuki Shintani3Masakazu Kotoda4Toru Matsuoka5Tadahiko Ishiyama6Takashi Matsukawa7Department of Anesthesiology, Faculty of Medicine, University of YamanashiDepartment of Anesthesiology, Faculty of Medicine, University of YamanashiDepartment of Anesthesiology, Yamanashi Prefectural Central HospitalDepartment of Anesthesiology, Kofu Municipal HospitalDepartment of Anesthesiology, Faculty of Medicine, University of YamanashiDepartment of Anesthesiology, Faculty of Medicine, University of YamanashiSurgical Center, University of Yamanashi Hospital, University of YamanashiDepartment of Anesthesiology, Faculty of Medicine, University of YamanashiAbstract Background With recent advances in robot-assisted techniques, an increasing number of surgeries are being performed with pneumoperitoneum and head-down maneuver (HDM) that may affect the cerebral microcirculation. For the first time, this study investigated the direct influence of pneumoperitoneum and HDM on the cerebral microvasculature in rabbits. Methods Adult male rabbits were randomly allocated to the following groups (n = 7 each): control, pneumoperitoneum alone (P), and pneumoperitoneum with HDM (P + HDM) for 120 min. A closed cranial window was installed above the parietal bone to visualize the pial microvasculature. Pial arteriolar diameter and hemodynamic and blood gas parameters were measured during the 140-min observation period. Brain edema was assessed by evaluation of the brain water content at the end of the experiment. Results Rabbits in the P and P + HDM groups exhibited a similar degree of immediate pial arteriolar dilation following the initiation of both P and P + HDM (P: 1.11 ± 0.03, p = 0.0044 and P + HDM: 1.07 ± 0.02, p = 0.0004, relative changes from the baseline value by defining the baseline as one). In the P + HDM group, pial arteriole diameter returned to the baseline level following the discontinuation of pneumoperitoneum and HDM (1.05 ± 0.03, p = 0.0906, vs. baseline). In contrast, the pial arterioles remained dilated as compared to the baseline level in the P group after discontinuation of pneumoperitoneum. There were no changes in pial arteriole diameter in the animals in the control group. Heart rate, blood gas parameters, and brain water content were not significantly different between the groups. Conclusion The pial arterioles dilated immediately after pneumoperitoneum with or without HDM. The pial arterioles remained dilated 20 min after discontinuation of pneumoperitoneum alone but constricted upon discontinuation of pneumoperitoneum plus HDM. Pneumoperitoneum and HDM for 2 h did not cause brain edema.https://doi.org/10.1186/s12871-022-01911-2PneumoperitoneumCerebral microcirculationBrain edema |
| spellingShingle | Hiroki Kobayashi Nobumasa Asano Daisuke Kondo Noriyuki Shintani Masakazu Kotoda Toru Matsuoka Tadahiko Ishiyama Takashi Matsukawa Influence of pneumoperitoneum and head-down maneuver on the cerebral microvasculature in rabbits BMC Anesthesiology Pneumoperitoneum Cerebral microcirculation Brain edema |
| title | Influence of pneumoperitoneum and head-down maneuver on the cerebral microvasculature in rabbits |
| title_full | Influence of pneumoperitoneum and head-down maneuver on the cerebral microvasculature in rabbits |
| title_fullStr | Influence of pneumoperitoneum and head-down maneuver on the cerebral microvasculature in rabbits |
| title_full_unstemmed | Influence of pneumoperitoneum and head-down maneuver on the cerebral microvasculature in rabbits |
| title_short | Influence of pneumoperitoneum and head-down maneuver on the cerebral microvasculature in rabbits |
| title_sort | influence of pneumoperitoneum and head down maneuver on the cerebral microvasculature in rabbits |
| topic | Pneumoperitoneum Cerebral microcirculation Brain edema |
| url | https://doi.org/10.1186/s12871-022-01911-2 |
| work_keys_str_mv | AT hirokikobayashi influenceofpneumoperitoneumandheaddownmaneuveronthecerebralmicrovasculatureinrabbits AT nobumasaasano influenceofpneumoperitoneumandheaddownmaneuveronthecerebralmicrovasculatureinrabbits AT daisukekondo influenceofpneumoperitoneumandheaddownmaneuveronthecerebralmicrovasculatureinrabbits AT noriyukishintani influenceofpneumoperitoneumandheaddownmaneuveronthecerebralmicrovasculatureinrabbits AT masakazukotoda influenceofpneumoperitoneumandheaddownmaneuveronthecerebralmicrovasculatureinrabbits AT torumatsuoka influenceofpneumoperitoneumandheaddownmaneuveronthecerebralmicrovasculatureinrabbits AT tadahikoishiyama influenceofpneumoperitoneumandheaddownmaneuveronthecerebralmicrovasculatureinrabbits AT takashimatsukawa influenceofpneumoperitoneumandheaddownmaneuveronthecerebralmicrovasculatureinrabbits |