Liver,biliary tract,pancreas,spleen

209338 Guard against "block phenomenon" for inferior vena cava being in compression during open cholecystectomy/Liu Guoying(刘国英,Dept Anesthesiol,Hangzhou 5th Peop Hosp,Hangzhou 311100)…∥Chin J Hepatobil Surg.-2009,15(6).-457～458Objective To explore the existence of "block phenomenon" of he inferior venal cava being in compression during open cholecystectomy.Methods A total of 30 patients receiving open cholecystectomy under the general anesthesia and epidural anesthesia in our hospital were selected.The right internal jugular vein and femoral vein catheterization was performed after the anesthesia induction and intubation to continuously monitor CVP and the in ferior vena cava pressure (IVCP).Meanwhil,the changes in CVP,MAP,HR,IVCP before abdominal opening,upon pulling gallbladder as well as 5 min,10 min and 15 minutes after the opening of deep retractors were observed,recorded and compared.Results The HR of patients during cholecystectomy did not changed significantly(P>0.05) but MAP an CVP were decreased markedly(P<0.01).Furtherore,there was remarkable increase of pressure in the inferior vena(P<0.01).These changes were the most obvious during the filling of saline gauze pads in the abdominal cavity and within the first 15 min of deep retractors led.After the closure of abdominal wall,the levels of CVP,MAP and IVCP returned to those before the abdominal opening.Conclusion The "block phenomenon" of the inferior vena cava during open cholecystectomy do exist in different degress and it is the main reason for the patients’ hemodynamic variety.This requires the anesthesiologists to hint the surgeon in the management of anesthesia to consider changing the posture and strength of retractors while the blood pressure is decreasing to avoid cardiovascular and cerebrovascular events.5 refs,1 tab.