Since 1987 when the first laparoscopic cholecystectomy, is performed up to our days, this surgical technique has had a boom due to its large medical and technological advances. Currently it is the technique of choice in the majority of hospitals for the treatment of cholecystitis, which is characterized anatomopathologically in varying degrees of inflammation and is accompanied by gallstones in 90% of cases.
The incidence of cholecystitis is estimated at at least 20% of women and 8% of men between 15 and 64 years of age. Annual hospital morbidity in our country in 2010 in our country was 84, 657 disbursements in women and 19, 058 disbursements in men. The mortality is estimated at 260 cases annually related to this pathology. (National system of health 2010).
Compared to open cholecystectomy, laparoscopic cholecystectomy is a surgery that requires little time of hospitalization and causes less pain due to surgical incisions more small. However laparoscopic cholecystectomy with all its benefits, is also a surgery that has adverse effects related to surgical technique, as it is the blow of the peritoneum, which physiologically interfere with anesthesia and requiring the anesthesiologist to use an anesthetic technique that allows optimal surgical conditions, deliver the patient a wide security, and minimize the risks of bronco aspirationarrhythmias, heart failure, pulmonary embolism, hypertension or hypotension, hypoxia, hypercapnia, and pneumothorax. They also must avoid side effects of the drugs used, decreasing the same requirements to provide the patient a quick and pleasant awakening, as well as a better control of postoperative pain and minimal side effects.
Therefore, since I started to use this surgical technique have been used a variety of anesthetic techniques in general anesthesia, with all kinds of inductors, agents inhalational and intravenous, relaxing muscles and pain relievers; in regional techniques such as epidural, block thoracic spinal lock lock, combination of general anesthesia blockade more epidural, and incisional and peritoneal infiltration of local anesthetic.
We start our review detailing the physiological changes caused by the pneumoperitoneum, parent of laparoscopic surgery.