Plasma catecholamine responses during laparoscopic gynecologic surgery with CO(2) insufflation

STUDY OBJECTIVE: To compare adrenergic-sympathetic responses during pelvic laparoscopic surgery with CO(2) insufflation with those during laparotomy. DESIGN. Prospective study (Canadian Task Force classification II-1). SETTING: Tertiary care university hospital. PATIENTS: Twenty-one infertile women with a clinical diagnosis of endometriosis. INTERVENTION: Plasma norepinephrine (NE) and epinephrine (E) levels were measured in patients undergoing laparoscopic or open pelvic surgery. MEASUREMENTS AND MAIN RESULTS: During laparoscopic surgery, increases in NE and E levels were correlated with arterial tension of CO(2) (PaCO(2)) and were greater in patients with a larger increase in PaCO(2) than in those undergoing laparotomy. Hemodynamic changes were also more evident during laparoscopic surgery, with larger PaCO(2) increases. CONCLUSION: The PaCO(2) increases due to CO(2) insufflation are associated with adrenergic-sympathetic activation and hemodynamic changes during laparoscopic pelvic surgery.