The Effect of Intraoperative Fluid Mangement on Haemodynamics during Laparoscopic Radical Cystectomy

Background: Prolonged pneumoperitoneum in laparoscopic radical cystectomy (LRC) leads to impairement in haemodynamics. This is manifested by increase in systemic vascular resistance, decrease in cardiac output and arrhythmias. Aim of the Study: To determine whether intraoperative fluid management could prevent cardiovasvular changes from hazards of pneumoperitonuem in patients undergoing laparoscopic radical cystectomy operations. Study Design: Randomized controlled trial. Methodology: Eighty patients with cancer bladder scheduled for laparoscopic radical cystectomy, classified by the American Society of Anesthesiologist (ASA) to class (ASAII or ASAIII) were divided into 2 equal groups group I received 2ml/kg/hr LR (Lactated ringer), group II received 8ml/kg/hr LR. Both groups received 8ml/kg LR as a preload. Results: No statistical significant difference was found in HR and MAP while there was statistical significant difference in CVP after 180 minutes T6 (5.6±2.42 versus 7.1±2.73). Conclusion: In patients undergoing laparoscopic radical cystectomy, intraoperative infusion of 8ml/kg/hr Lactated Ringer could maintain haemodynamic stability without causing pulmonary edema or volume overload compared to low volume infusion of 2ml/kg/hr Lactated Ringer.