Haemodynamic changes during laparoscopic anterior fundoplication measured by trans-oesophageal Doppler ultrasound.

Abstract

We investigated the cardiovascular effects of pneumoperitoneum and steep head-up tilt during laparoscopic fundoplication using an intra-oesophageal Doppler ultrasound probe. Repositioning of the probe proved sufficient to maintain the signal throughout the procedure despite the pneumomediastinum. There was a statistically significant increase in mean arterial blood pressure and a fall in stroke distance but not in systemic vascular resistance. Increasing or decreasing the blood pressure with drugs improved stroke distance. The oesophageal Doppler ultrasound proved a satisfactory method for assessing cardiovascular changes during fundoplication.