Evaluation of Hemodynamic Changes Using Different Intra-Abdominal Pressures for Laparoscopic Cholecystectomy under General Anesthesia

Purpose: Laparoscopic cholecystectomy (LC) requires carbon dioxide pneumoperitoneum to establish a surgical field, which increases intra-abdominal pressure (IAP) and can affect cardiopulmonary function.Understanding these hemodynamic changes is crucial for optimizing intraoperative safety.This study evaluated the effects of varying IAP levels on hemodynamic parameters during LC to identify the optimal pressure range for cardiovascular stability.Methods: A prospective observational study was conducted at Rawal General and Dental Hospital, Islamabad, including 150 patients aged 18-60 years (ASA I-II) undergoing LC under general anesthesia.Patients were allocated into three groups: Group A (15 mmHg).Heart rate, systolic and diastolic blood pressure, mean arterial pressure (MAP), end-tidal CO₂, and oxygen saturation were recorded at baseline (T0), post-induction (T1), after pneumoperitoneum (T2), 10 min (T3), 20 min (T4), and post-desufflation (T5).Data were analyzed using one-way ANOVA (p < 0.05).Results: Of 150 patients, 80.7% (n = 121) were overweight (BMI 25-29.9kg/m²).Pneumoperitoneum duration differed significantly among groups (F = 8.81, p ≤ 0.001).Lower IAP (8-10 mmHg) resulted in shorter operative times (75.7 ± 5.0 min) and fewer hemodynamic fluctuations.Higher IAPs were associated with increased systolic blood pressure and MAP.Conclusion: Elevated intra-abdominal pressure during LC significantly affects hemodynamic stability.Maintaining an IAP of 8-10 mmHg minimizes cardiovascular variations and promotes safer intraoperative outcomes.