Prevalencia de alteraciones hemodinámicas y ventilatorias intraoperatorias en cirugía laparoscópica y factores de riesgo asociados. Hospitales José Carrasco Arteaga y Vicente Corral Moscoso. Cuenca, 2017-2018

Abstract

Introduction: Hemodynamic and ventilatory alterations are frequent findings in laparoscopic surgery, being more noticeable in those patients with associated pathology, although they commonly go unnoticed in daily practice. Objective: To determine the intraoperative hemodynamic and ventilatory alterations in laparoscopic surgery and the associated risk factors in the Hospital José Carrasco Arteaga and Vicente Corral Moscoso in the city of Cuenca during 2017-2018. Methodology: An observational, analytical and cross-sectional study was conducted in the year 2017-2018. The population consisted of patients undergoing laparoscopic surgery (cholecystectomy and appendectomy) who met the inclusion criteria; the sample was representative and random, the data were collected directly in the form during the transoperative period and were tabulated and analyzed with SPSS system 22. For the hypothesis test RP, IC95% and p-value <0.05 were applied. Results: We studied 446 cases, observing that the most frequent age group is between 21 and 60 years old (77.6%), with a predominance of females (65.5%), hemodynamic alterations were present in 204 patients (45,7%) and ventilatory in 220 patients (49.3%), the age group older than 60 years had a strong association with hemodynamic variations (69.7%) as well as ventilatory (62.1%), being both statistically significant cases (p: 0,000 and 0,008 ). Among the risk factors, ASA II and III (55.9% and 55.6%), obesity (60%) and arterial hypertension (60.9%) showed significant association with hemodynamic variations; whereas the risk factors that were significantly associated with ventilatory variations are ASA II and III (61.5% and 74.1%), obesity (72.6%), surgical risk class III (75%) and hypertension arterial (64.1%). Conclusion: pneumoperitoneum is responsible for a large part of the hemodynamic and ventilatory alterations, there is a strong association between some variables with these changes, however there are no studies that allow to relate all the parameters analyzed.