Abstract

Arshad Jamal* and Jalad Kapoor

ABSTRACT

Introduction: There have been repeated references to reflexes arising from the upper abdominal viscera and especially the biliary tract that could give rise to cardiac arrhythmias, a reduction in coronary blood flow and even catastrophe during surgery of the biliary tract. Various procedures and techniques including paravertebral and/ or intercostal block as well as extradural or even intradural block have been tried in past in order to evaluate this phenomena by different workers but with highly variables result. Aims and Objectives: Cholecystocardiac Link Intra-Operative Evaluation During Biliary Tract Surgery. Methods and Material: Sixty adult patients of ASA class I & II (American Society of Anaesthetists) who were posted for elective cholecystectomy and/or common bile duct exploration were taken up for the study. Out of sixty patients 30 patients were normotensive (Group A) and rest of 30 patients were treated hypertensive patients (Group B).Patients with Arrhythmia, IHD and diabetes and with untreated hypertension were excluded from the study. Results: In the present study, patients’ age ranged from 27-45 years (mean 36.33) in Group A and from 25-49 years (mean 35.6) in Group B. Male: Female ratio was 1:14 and 1:9 in Group A and Group B respectively. Pulse rate, heart rhythm, systolic blood pressure, diastolic blood pressure, mean arterial pressure, and rate pressure product during different stages of anaesthesia and surgery in normotensive patients (Gp.A) and treated hypertensive (Gp.B) patients were statistically compared. Conclusion: The measured parameters increased significantly during surgical manipulation. Hemodynamic disturbances secondary to diseased gall bladder and its removal are more marked when cardiovascular system is the seat of proclaimed or latent disorder.