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Reasons - multi-factorial:
1. Reduced manipulation of the bowel and peritoneum
1.
Rate-4-6 L/min
10-20 mmHg
Constant gas flow 200-400 ml/m
Carbondioxide
Complications-more insidious
2.
Procedure related
Positional-Complications
Pneumoperitonium
Patient specific
Incorrect positioning of
needle/trochar/anatomical anomalies/gas
dissecting across weak tissue planes Subcut
emphysema, pneumomediastinum,
pneumothorax
Retroperitonial hematomas
V/Q mismatch
Greater risk of atelectasis
Cephalad movement of lungs & carina in relation to
the fixed ET tube endobronchial intubation
Initially VRCOcompensatory vasodilatation
Obesity
Hypotension
Reduced VR CO
SVR CO, BP
RESPIRATORY EFFECTS
NEUROLOGICAL EFFECTS
4.
Analgesia
elderly/associated morbidity
Contraindications
severe IHD
valvular disease
Ventilation
GI
Antiemetics
Monitoring