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Incidence of Neurological, Ophthalmic and Otological Symptoms in Laparoscopic Surgery in Post Operative Period: An Observational Study

Sneha Shivnani , Sneha Shivnani 1 , Sarojini Bobde 2 , Sarita Swami 3 , Vasu Vashishtha 4

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Indian Journal of Anesthesia and Analgesia 8(4):p 15-20, July-August 2021. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.8421.62

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Sneha Shivnani, Sarojini Bobde, Sarita Swami, Vasu Vashishtha/Incidence of Neurological, Ophthalmic and Otological Symptoms in Laparoscopic Surgery in Post Operative Period: An Observational Study/Indian J Anesth Analg. 2021;8(4):433-438.

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Received : N/A         Accepted : N/A          Published : N/A

Abstract

Context: Laparoscopic surgery technique creates certain changes in various systems presenting as post-operative side effects and symptoms. Aims: To observe incidence of post-operative neurological, ophthalmic and otological symptoms in patients undergoing laparoscopic surgery. Setting and Design: Institutional setting, retrospective observational study Material and methods: After ethical committee clearance, 100 patients undergoing laparoscopic surgery, meeting inclusion criteria were included in the study. Patients were monitored intraoperatively for haemodynamic changes;EtCO2, Ppeak. After extubation in post-operative period, patientswere monitored for signs and symptoms in PACU, after 4 hours and 2nd post-operative day and system specific symptoms noted. Statistical analysis used: Data collection done using SPSS 21.0. Analysis of collected data done using independent t test, paired t test, chi-square test and Fischer’s test. Results: Out of 100 patients,36 patients showed symptoms. 8 patients had BMI >35kg/m2, 7 out of them had neurological (p value=0.14) and all 3 neurological, ophthalmic and otological symptoms. Trendelenburg combined with lithotomy position was used in 7 patients, 6 patients showed symptoms, 5 of them showed neurological symptoms (p value=0.006) and 3 showed ophthalmic symptoms (p value=0.002). Total colorectal surgeries done were 5, out of which 4 showed symptoms. Total gynaecological surgeries done were 10, out of which 7 showed symptoms, neurological=6 and ophthalmic=3. Mean duration of insufflation in neurological symptoms- 4.06hrs (p-value 0.007), for ophthalmicsymptoms-4hrs (p-value 0.334) and otological symptoms-8hrs (p-value 0.002). Certain parameters like EtCO2, Peak airway pressures, increased during insufflation and continued to remain high even after desufflation (P value=0.0001). Age of the patients, Intra-abdominal pressure (IAP) and comorbidities did not show significant impact on incidence of symptoms. Conclusion: Trendelenburg with lithotomy position, higher BMI, longer duration of insufflation can be major factors contributing to neurological and ophthalmic symptoms in laparoscopic surgeries.

 

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Sneha Shivnani, Sarojini Bobde, Sarita Swami, Vasu Vashishtha/Incidence of Neurological, Ophthalmic and Otological Symptoms in Laparoscopic Surgery in Post Operative Period: An Observational Study/Indian J Anesth Analg. 2021;8(4):433-438.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.8421.62

Keywords

Laparoscopic surgery; Neurological symptoms; Pneumoperitoneum; Trendelenburg’s position.

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