Parâmetros eficientes do posicionamento adequado da ponta da agulha de veress durante o estabelecimento de pneumoperitônio

• Autor(a) principal: Azevedo, Otávio Cansanção [UNIFESP]
• Data de Publicação: 2006
• Outros Autores: Azevedo, João Luiz Moreira Coutinho [UNIFESP], Sorbello, Albino Augusto [UNIFESP], Miguel, Gustavo Peixoto Soares [UNIFESP], Guindalini, Rodrigo Santa Cruz [UNIFESP], Godoy, Antônio Cláudio de
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1590/S0100-69912006000400005; http://repositorio.unifesp.br/handle/11600/3156
• topic: Laparoscopy; Surgical procedures, operative; Pneumoperitoneum, artificial; Punctures; Laparoscopia; Procedimentos cirúrgicos operatórios; Pneumoperitônio artificial; Punções

BACKGROUND: To evaluate the possibility of establishing reliable parameters for the appropriate positioning of Veress needle tip in the peritoneal cavity during pneumoperitoneum creation. METHODS: In 100 selected patients Veress needle tip were introduced in the peritoneal cavity and the insufflators were programmed for a flow of 1,2L/min and with final maximum pressure of 12mmHg. At the beginning of the insufflation and at every 20 seconds the intraperitoneal pressure (IP) and the total volume injected (TVI) were recorded. Data was treated by statistical correlation between moments and IP, and moments and TVI. The forecast values of IP and TVI at the end of each one of the four first insufflation minutes were also established, using the following estimated formulas: IP = 2.3083 + 0.0266 x time + 8.3x10-5 x time³ - 2.44x10-7 x time³; TVI = 0.813 + 0.0157 x time. RESULTS: IP and TVI showed a correlation between pre-established moments of pneumoperitoneum creation when a strong adjustment became apparent: IP = -2E - 07 x time³ + 8E - 05 x time² + 0.0266 x time + 2.3083, with a coefficient of explanation: (R2) = 0.8011; TVI = 0.0157 x time + 0.1813, with R2=0.9604. The forecast of IP and TVI showed: IP (mmHg): 1min=4.15; 2 min=6.27; 3 min=8.36; 4 min=10.10 and TVI (L): 1min=1.12; 2 min=2.07; 3 min=3.01; 4 min=3.95. CONCLUSION: Reliable parameters for IP and TVI can be established during pneumoperitoneum creation when the Veress needle tip is located in the peritoneal cavity in a given insufflation moment.