Objective:To study the effect of different laparoscopic surgery position and different CO2 pneumoperitoneum pressure on femoral venous hemodynamics.
Methods :Color Doppler ultrasound was adopted to evaluate the diameter、blood velocity and volume of the blood flow in the lower extremity of thirty patients undergoing laparoscopy in three different of positions(supine, head-down tilt position and feet-down tilt position) before the establishment of pneumoperitoneum and with three different pressure of pneumoperitoneum(8 mmHg,12 mmHg,16 mmHg).
Results:Compared with supine position before the pneumoperitoneum,the femoral vein diameter decreased (P<0.05),the velocity and the volume of blood flow increased (P<0.01,P<0.05) with head-down tilt position;the femoral vein diameter increased (P<0.01),the velocity and the volume of blood flow decreased (P<0.01,P<0.05) with feet-down tilt position on the establishment of pneumoperitoneum. Furthermore,with the increase of pneumoperitoneum pressure,the femoral vein diameter increased,the velocity and the amount of blood flow decreased (P<0.05).
Conclusions:The head-down tilt position is conducive for the blood to recirculate,which could decrease the risk of deep vein thrombosis after laparoscopy.The feet-down tilt position and high CO2 pneumoperitoneum pressure can interfere with the recirculation of blood,and could increase the risk of deep vein thrombosis after laparoscopy.