Correlation of Intra Abdominal Pressure with Intra and Post Operative Anesthetic Complications

Intra-abdominal pressure, (IAP), is the pressure inside the abdominal cavity. Its normal value has not been defined clearly, but it may range from sub-atmospheric to about 7 mmHg. Intra-abdominal hypertension, defined as IAP greater than 12 mmHg, has been reported in critically ill patients and is associated with cardio-respiratory and renal co-morbidities. The effect of borderline values of IAP on the peri-operative morbidities has not been investigated in previous studies. This study was designed to investigate the effect of high normal values of IAP on anesthesia-related peri-operative complications.

Intra-abdominal pressure was measured before induction of general anesthesia in 60 adult non-obese patients scheduled for elective orthopedic surgery. Patients were observed throughout the operative and recovery period for any evidence of anesthesia-related complications viz. oxygen desaturation, hypertension, dysrhythmia etc. Patients were categorized into two group, those with >2 episodes of complications, and those with ≤2 episodes.

Thirty-three patients experienced >2 episodes of complications. The mean IAP was 8.21±2.1 mmHg in this group and was significantly different from the group with fewer complications in whom the mean IAP was 4.2±1.51 mmHg, (p<0.05). Binary logistic regression analysis showed that IAP was an independent predictor for development of anesthesia-related complications with an Odds ratio of 1.4 (1.17-1.81, p=0.015).

The result of this study shows that high normal values of IAP are an independent predictor for the development of peri-operative anesthesia-related complications.