Association between laparoscopic abdominal surgery and postoperative symptoms of raised intracranial pressure

Animal models have illustrated that a carbon dioxide (CO2) pneumoperitoneum can cause a rise in intracranial pressure (ICP). This study investigated key symptoms and signs of raised ICP in 39 patients after laparoscopic abdominal surgery and compared them with a control group of 33 patients after open operations. The findings show that the incidence of headache and nausea was significantly higher in the laparoscopic group than in the control subjects. End-tidal CO2 levels were recorded, and no significant difference was found between patients and control subjects. We conclude that these results could be explained by raised intracranial pressure exacerbated by the CO2 pneumoperitoneum, and that this effect is not mediated by raised expiratory CO2 levels intraoperatively.