Recovery and Postoperative Monitoring
Hemodynamic monitoring should be continued in the postanesthesia
care unit (see Chapter 71
).
Hemodynamic changes induced by the pneumoperitoneum, and more particularly the increased
systemic vascular resistance, outlast the release of the pneumoperitoneum. The hyperdynamic
state developing after laparoscopy could conceivably lead to a precarious hemodynamic
situation in patients with cardiac disease.[103]
[147]
Despite the reduction in postoperative pulmonary dysfunction,
PaO2
still decreases after laparoscopic
cholecystectomy.[3]
[177]
[213]
Increased oxygen demand is observed after
laparoscopy. Although laparoscopy tends to be considered a minor surgical procedure,
oxygen should be administered postoperatively, even to healthy patients.[323]
During the early postoperative period, respiratory rate and PETCO2
of patients breathing spontaneously are higher after laparoscopy as compared with
open surgery.[32]
Prevention and treatment of nausea, vomiting, and pain are important,
particularly after outpatient laparoscopic procedures. This issue has been addressed
previously.
