Which cardiovascular complication related to pneumoperitoneum can be mitigated by certain preoperative medications?

Which cardiovascular complication related to pneumoperitoneum can be mitigated by certain preoperative medications?

• A. Hypertension
• B. Nausea
• C. Bradyarrhythmias (correct)
• D. Hyperglycemia

Answer: (C)

Pneumoperitoneum with CO2 can trigger a vagal reflex as the peritoneum stretches and intraabdominal pressure rises, leading to bradycardia or bradyarrhythmias. Giving anticholinergic premedication, such as glycopyrrolate or atropine, reduces vagal tone by blocking muscarinic receptors, which blunts this reflex and lowers the likelihood of bradycardia during insufflation. Hypertension, hyperglycemia, and nausea aren’t driven by this vagal mechanism in the same way, so they aren’t mitigated by these preoperative anticholinergic medications.

Pneumoperitoneum with CO2 can trigger a vagal reflex as the peritoneum stretches and intraabdominal pressure rises, leading to bradycardia or bradyarrhythmias. Giving anticholinergic premedication, such as glycopyrrolate or atropine, reduces vagal tone by blocking muscarinic receptors, which blunts this reflex and lowers the likelihood of bradycardia during insufflation. Hypertension, hyperglycemia, and nausea aren’t driven by this vagal mechanism in the same way, so they aren’t mitigated by these preoperative anticholinergic medications.