INTRA-ABDOMINAL PRESSURE MEASUREMENT IN PATIENTS UNDERGOING ABDOMINAL SURGERY

Background: Intra-abdominal pressure (IAP) is the steady state pressure present within the abdominal cavity. Normal IAP ranges from sub atmospheric to 0mmHg. IAP gets altered in patients undergoing abdominal surgeries. Increased IAP will have adverse effect on organ systems. The study aimed to compare IAP changes and their significance in patients undergoing abdominal surgeries. This study also assessed the effect of IAP on renal, respiratory and cardiovascular systems (CVS). Materials and Methods: This prospective observational study included137 patients who underwent abdominal surgeries. Abdominal surgeries included were emergency laparotomy (35cases), elective laparotomy (35cases), ventral hernia repairs (35cases) and laparoscopic procedures (32cases).Chi square, ANOVA, Mann Whitney and Bonferroni statistical tests were used for analysis. IAP was measured in the preoperative period and post-operatively at 0, 24 and 48 hours using a Foleys catheter inserted into the urinary bladder. Results: In emergency laparotomy group IAH was noted preoperatively in 88.58% cases. Post op IAH was observed in 74.28%, 57.14% and 18% at 0, 24 and 48 hours respectively. In elective laparotomy group IAH was noted in 11.42%cases pre-operatively. Post op IAH was observed in 34.27%, 14.28% at 0 and 24hours post-op. In ventral hernia repairs IAH noted in 45.7%, 14.28% cases at 0 and 24hours post-op. No IAH was noted in laparoscopic procedures group. There was significant effect of preoperative and post-operative IAH on renal, respiratory and CVS in emergency laparotomy group. Among ventral hernia repair group, with post-op IAH at 0 hours, renal system was affected in 25% and respiratory system was affected in 18.75% of patients. In elective laparotomy patients with post op IAH at 0 hours, renal system affected in 33% cases and respiratory system affected in 25% cases. Conclusion: There were significant changes in IAP in abdominal surgeries from preoperative to post-operative period. These changes had significant effects on renal, respiratory and cardiovascular systems especially in emergency surgery group. Hence close monitoring of renal, respiratory and cardiovascular parameters are mandatory in patients who develop raised IAP in the pre and post-operative period.