Hasil untuk "Anesthesiology"

J. Soar, J. Nolan, B. Böttiger et al.

Gilda Pasta, Luciano Frassanito, Maria Maciariello et al.

Abstract Background Intraoperative fluid management during major abdominal oncologic surgery is complex and highly operator-dependent. Assisted Fluid Management (AFM) is an artificial intelligence–based decision support system designed to guide fluid challenges based on real-time Stroke Volume (SV) analysis. However, limited data are available on how AFM is adopted in routine clinical practice and how clinician interaction with the system evolves over time. Methods We conducted a retrospective observational study based on a prospectively maintained institutional database at a high-volume tertiary referral center. Adult patients undergoing major abdominal oncologic surgery with intraoperative AFM monitoring were included. Two consecutive time periods following AFM implementation were compared. Analyses were performed at the fluid-challenge level and focused on patterns of fluid challenge initiation (clinician-initiated vs AFM-suggested), hemodynamic effectiveness (SV response), and bolus characteristics, as markers of system adoption and learning curve. Postoperative clinical outcomes were not assessed. Results Fifty-nine patients were included, accounting for 404 fluid challenges. Over time, clinician-initiated boluses significantly decreased and AFM-suggested fluid challenges increased (p < 0.001). This shift was associated with higher overall effectiveness of fluid challenges and greater SV responses, particularly for AFM-suggested boluses, which showed a significant improvement in effectiveness and ΔSV over time (p < 0.05). Conclusions Progressive integration of AFM into routine anesthetic practice was associated with measurable changes in clinician behavior and improved physiological effectiveness of intraoperative fluid challenges over time, consistent with a learning curve effect. These findings support the role of AI-based decision support systems in promoting more consistent and physiologically targeted fluid management and provide a foundation for future prospective studies evaluating their impact on clinical outcomes.

Mengting Xu, Huiqing Gao, Renji Zheng et al.

Abstract Background This study was conducted to explore whether liposomal bupivacaine for the suprascapular nerve combined with axillary nerve block can provide noninferior postoperative analgesia and reduced hemidiaphragmatic paralysis (HDP) versus traditional interscalene brachial plexus block in patients undergoing arthroscopic shoulder surgery. Methods Patients were divided into a suprascapular nerve and axillary nerve block group (SSANB group) and an interspinal brachial plexus block group (IBB group) via a random number table. The local anesthetic used was a mixture of 1.33% liposomal bupivacaine and 0.5% levobupivacaine hydrochloride injected in equal volume. The primary outcome measures included resting numerical rating scale (NRS) scores at 72 h after surgery and the incidence of HDP 30 min after block. Results Finally, 48 patients were included. The incidence rates of HDP in the SA and IB groups were 4% (1/25) and 78.3% (18/23), respectively, with statistical significance (P < 0.001). The motor block duration in group IB was significantly longer than that in group SA (30.57 ± 17.13 vs. 0.88 ± 4.40 h, P < 0.001). There were no significant differences in the NRS score at rest after surgery, opioid consumption, satisfaction with analgesia, sensory block duration, perioperative adverse effects, or neurological complications between the two groups (all P > 0.05). Conclusions Liposomal bupivacaine for the suprascapular nerve combined with axillary nerve block can provide long-term postoperative analgesia that is noninferior to traditional interscalene brachial plexus block and results in fewer HDP occurrences in patients undergoing arthroscopic shoulder surgery. Trial registration This study was registered at www.chictr.org.cn on June 28, 2024 (registration number: ChiCTR2400086331).

Strametz R, Roesner H, Neusius T et al.

Reinhard Strametz,1,&ast; Hannah Roesner,1,2,&ast; Thomas Neusius,1,&ast; Isabell Wiesenhuetter,1 Stefan Bushuven,3,4 José Joaquín Mira,2,5 Dominik Hinzmann,6 Susanne Heininger7 1Wiesbaden Institute for Healthcare Economics and Patient Safety, RheinMain UAS, Wiesbaden, Germany; 2Miguel Hernández University of Elche, Elche, Spain; 3Training Center for Emergency Medicine (NOTIS e.V), Engen, 78234, Germany; 4Department of Anesthesiology and Critical Care, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, 79106, Germany; 5Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), Alicante, Spain; 6Department Clinical Medicine, Department of Anesthesiology and Intensive Care, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany; 7Faculty for Applied Healthcare Sciences, Deggendorf Institute of Technology, Deggendorf, Germany&ast;These authors contributed equally to this workCorrespondence: Reinhard Strametz, Wiesbaden Institute for Healthcare Economics and Patient Safety, RheinMain UAS, Bleichstr. 3, Wiesbaden, 65183, Germany, Email reinhard.strametz@hs-rm.dePurpose: The objective of this study is to evaluate whether the nationwide establishment and institutionalization of a peer-support program, is economically justified given the potential positive effects on the Second Victim Phenomenon (SVP) among healthcare professionals in Germany.Methods: A comprehensive methodological approach was employed, using data from the SeViD studies to assess the prevalence and duration of SVP among physicians and nurses in Germany. Economic impact assessments were conducted to estimate the potential cost savings associated with implementing a peer-support program.Results: The economic analysis reveals significant annual costs associated with SVP-induced absenteeism: approximately 1.56 billion euros for physicians and 1.87 billion euros for nurses. Implementing comprehensive peer-support programs could reduce these costs to approximately 0.85 billion (physicians) and 1.02 billion euros (nurses), respectively, demonstrating substantial potential economic benefits.Conclusion: Investing in a structured peer-support program could yield annual savings exceeding 1.55 billion euros while enhancing workforce resilience and improving patient care. This underscores the economic rationale for scaling up peer support initiatives in healthcare settings.Keywords: peer support program, economic impact, second victim phenomenon, healthcare professionals

Eric Edelman, Fabian Tijssen, Popke Rein Munniksma et al.

Hyung-Been Yhim, MD, Seokha Yoo, MD, Sun-Kyung Park, MD et al.

Background: Single-injection adductor canal block (SACB) is one of the multimodal pain managements in total knee arthroplasty. The effect of an intrathecal local anesthetic is prolonged with an intraoperative dexmedetomidine infusion. Currently, SACB’s effect along with the prolonged spinal anesthesia effect by dexmedetomidine has not been studied elsewhere. Methods: Seventy-eight patients were randomized to either the SACB group (n = 39) or the control group (n = 39). Spinal anesthesia and continuous infusion of dexmedetomidine were performed intraoperatively. The SACB was performed using 15 mL of either 0.5% ropivacaine or normal saline in postanesthesia care unit postoperatively. Primary endpoint examined the average numerical rating scale (NRS) pain scores at 2, 6, 12, and 24 hours after SACB while resting or moving. The secondary outcomes were the morphine equivalent, postoperative nausea and vomiting score, quadriceps strength, and overall satisfaction score. Results: The SACB group showed a lower average NRS pain score until 24 hours than the control group (2.4 vs 3.3 resting, 3.4 vs 4.1 moving). Resting and moving NRS scores at 6 and 12 hours were significantly lower in the SACB group, whereas no difference was found at 2, 24, and 48 hours, regardless of movement. The satisfaction score was higher in the SACB group than in the control group (9 [7.3-10.0] vs 7 [5.3-8.8]), and morphine equivalent at 2 hours was lower in the SACB group (2 [1-3]) than in the control group (2.9 [1.6-4]). Conclusions: SACB provided an additional analgesic effect in patients undergoing total knee arthroplasty under spinal anesthesia with continuous dexmedetomidine intravenous infusion.

José Luis Guerrero-Orriach, Maria Dolores Carmona-Luque, Guillermo Quesada Muñoz et al.

Background: The effects of anesthetic drugs on myocardial cells have been a subject of research for the last 50 years. The clinical benefits of halogenated agents, particularly sevoflurane, have been demonstrated in cardiac surgery patients. These benefits are due to the action of different enzymes and a variety of molecular pathways mediated by the action of small noncoding RNAs (sRNA) such as microRNAs (miRNAs). However, the modulation potential induced by anesthetic drugs on the miRNA expression and their cardioprotective effects is unknown. Objective: To analyze the variation in the expression of a panel of miRNAs induced by halogenated agents to identify their cardioprotective effects. Aims: Variations in the expression of specific miRNAs induce the potential cardioprotective effects of halogenated agents. Methods: An ischemia/reperfusion (I/R) in vitro model of primary human cardiac myocytes (HCMs) was performed. Four study groups were performed: control group (standard culture conditions), I/R group (without hypnotic drugs exposition), I/R-propofol group (I/R-P), and I/R-sevoflurane group (I/R-S). The secretion of p53 and Akt1 cytokines was quantified in the different cell study groups using an Enzyme-Linked ImmunoSorbent Assay, and the differentially expressed miRNAs were identified carrying out a complete genomic sequencing using the Next Generation Sequencing (NGS). Results: HCMs subjected to the I/R procedure and exposed to sevoflurane showed lower secretion levels of p53 factor and higher levels of Akt-1 cytokine compared to HCMs exposed to propofol (p53: I/R-S: 10.43 ± 0.91 ng/mL; I/R-P: 137.92 ± 7.53 ng/mL; <i>p</i> > 0.05); (Akt1: I/R-S: 0.62 ± 0.12 ng/mL; I/R-P: 0.23 ± 0.05 ng/mL; <i>p</i> > 0.05). The miRNA gene expression analysis (NGS) showed significantly increased expression of the hsa-miR-140-5p and hsa-miR-455-5p, both miRNAs associated with cardiac function; the hsa-miR-98-5p and hsa-miR-193a-5p, both related to apoptosis inhibition; and the hsa-let-7d-5p associated with myocardial protection. This increase was observed in the HCMs group exposed to sevoflurane in comparison to the propofol group. Conclusions: Sevoflurane-induced miRNAs overexpression confers cardioprotection through various mechanisms at the DNA level and the different signaling pathways levels, such as Akt/ERK.

Eva M. Schmitt, Rob Tanzola, Jordan Oberhaus et al.

Background:  There is some evidence that electroencephalography guidance of general anesthesia can decrease postoperative delirium after non-cardiac surgery.  There is limited evidence in this regard for cardiac surgery.  A suppressed electroencephalogram pattern, occurring with deep anesthesia, is associated with increased incidence of postoperative delirium (POD) and death.  However, it is not yet clear whether this electroencephalographic pattern reflects an underlying vulnerability associated with increased incidence of delirium and mortality, or whether it is a modifiable risk factor for these adverse outcomes. Methods:  The Electroencephalography Guidance of Anesthesia to Alleviate Geriatric Syndromes (ENGAGES-Canada) is an ongoing pragmatic 1200 patient trial at four Canadian sites.  The study compares the effect of two anesthetic management approaches on the incidence of POD after cardiac surgery.  One approach is based on current standard anesthetic practice and the other on electroencephalography guidance to reduce POD. In the guided arm, clinicians are encouraged to decrease anesthetic administration, primarily if there is electroencephalogram suppression and secondarily if the EEG index is lower than the manufacturers recommended value (bispectral index (BIS) or WAVcns below 40 or Patient State Index below 25).  The aim in the guided group is to administer the minimum concentration of anesthetic considered safe for individual patients.  The primary outcome of the study is the incidence of POD, detected using the confusion assessment method or the confusion assessment method for the intensive care unit; coupled with structured delirium chart review.  Secondary outcomes include unexpected intraoperative movement, awareness, length of intensive care unit and hospital stay, delirium severity and duration, quality of life, falls, and predictors and outcomes of perioperative distress and dissociation. Discussion:  The ENGAGES-Canada trial will help to clarify whether or not using the electroencephalogram to guide anesthetic administration during cardiac surgery decreases the incidence, severity, and duration of POD. Registration: ClinicalTrials.gov (NCT02692300) 26/02/2016

Mayuri Gupta, Avani Tiwari, Aditi Lather

Abstract Background Protein C deficiency is a rare genetic disorder with varying severity of symptoms and disease. The disorder may vary in presentation from a complete symptomless state to a less severe form like venous thromboembolism. The most severe form of disease is a rare condition called neonatal purpura fulminans (NPF) which is characterized with sudden progressive dermal hemorrhage and necrosis due to vascular thrombosis and disseminated intravascular coagulation. In contrast, congenital atrial and ventricular septal defects are the commonest congenital heart diseases found in pediatric population. An infant presenting with systemic vascular thromboembolism secondary to protein C deficiency along with the cardiac septal defects posted for surgery will be a very challenging task to manage in perioperative period. Also, physiological mechanisms during perioperative period and surgery will promote thromboembolism leading to worsening of the situation further. So, perioperative management of such patient pose a great challenge to the anaesthesiologist. Due to rarity of the condition, there is very limited literature available. Case presentation We report the perioperative management of a 2-month-old child suffering with neonatal purpura fulminans with atrial and ventricular septal cardiac defect, scheduled for bilateral foot amputation. The patient was a diagnosed with complete occlusion of abdominal aorta leading to foot gangrene. After initiation of anticoagulant therapy, symptoms were relieved and patient was posted for amputation of gangrenous feet. Conclusions There could be an increased risk of thromboembolism and bleeding due to protein C abnormality along with the chances of shunt reversal, paradoxical embolism, and other cardiac morbidities secondary to septal defects. Wise selection of anaesthetic agents like limiting the use of nitrous oxide, ketamine as much as possible to be considered. Conditions like tachycardia, hypotension, and hypothermia should also be prevented perioperatively as these could increase the chances of thrombosis.

Holger A. Lindner, Shigehiko Schamoni, Thomas Kirschning et al.

Abstract Background Sepsis is the leading cause of death in the intensive care unit (ICU). Expediting its diagnosis, largely determined by clinical assessment, improves survival. Predictive and explanatory modelling of sepsis in the critically ill commonly bases both outcome definition and predictions on clinical criteria for consensus definitions of sepsis, leading to circularity. As a remedy, we collected ground truth labels for sepsis. Methods In the Ground Truth for Sepsis Questionnaire (GTSQ), senior attending physicians in the ICU documented daily their opinion on each patient’s condition regarding sepsis as a five-category working diagnosis and nine related items. Working diagnosis groups were described and compared and their SOFA-scores analyzed with a generalized linear mixed model. Agreement and discriminatory performance measures for clinical criteria of sepsis and GTSQ labels as reference class were derived. Results We analyzed 7291 questionnaires and 761 complete encounters from the first survey year. Editing rates for all items were > 90%, and responses were consistent with current understanding of critical illness pathophysiology, including sepsis pathogenesis. Interrater agreement for presence and absence of sepsis was almost perfect but only slight for suspected infection. ICU mortality was 19.5% in encounters with SIRS as the “worst” working diagnosis compared to 5.9% with sepsis and 5.9% with severe sepsis without differences in admission and maximum SOFA. Compared to sepsis, proportions of GTSQs with SIRS plus acute organ dysfunction were equal and macrocirculatory abnormalities higher (p < 0.0001). SIRS proportionally ranked above sepsis in daily assessment of illness severity (p < 0.0001). Separate analyses of neurosurgical referrals revealed similar differences. Discriminatory performance of Sepsis-1/2 and Sepsis-3 compared to GTSQ labels was similar with sensitivities around 70% and specificities 92%. Essentially no difference between the prevalence of SIRS and SOFA ≥ 2 yielded sensitivities and specificities for detecting sepsis onset close to 55% and 83%, respectively. Conclusions GTSQ labels are a valid measure of sepsis in the ICU. They reveal suspicion of infection as an unclear clinical concept and refute an illness severity hierarchy in the SIRS-sepsis-severe sepsis spectrum. Ground truth challenges the accuracy of Sepsis-1/2 and Sepsis-3 in detecting sepsis onset. It is an indispensable intermediate step towards advancing diagnosis and therapy in the ICU and, potentially, other health care settings.

Boohwi Hong, Chahyun Oh, Yumin Jo et al.

Fascial plane blocks are useful for multimodal analgesia after cardiac surgery since they can provide effective analgesia without the serious risks associated with conventional techniques such as neuraxial hematoma and pneumothorax. This narrative review covers blocks performed at the parasternal intercostal, interpectoral, pectoserratus, serratus anterior, erector spinae, and retrolaminar planes, which are targets for fascial plane blocks in cardiac surgery. Brief anatomical considerations, mechanisms, and currently available evidence are reviewed. Additionally, recent evidence on fascial plane blocks for subcutaneous-implantable cardioverter-defibrillator implantation are also reviewed.

Weiwei Qin, He Huang, Yuting Dai et al.

Abstract Background Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory airway disease caused by inhalation of cigarette smoke (CS) and other harmful gases and particles. Methods This study aimed to explore potential urinary biomarkers for CS-induced COPD based on LC–MS/MS analysis. Results A total of 340 urinary proteins were identified, of which 79 were significantly changed (30, 31, and 37 at week 2, 4 and 8, respectively). GO annotation of the differential urinary proteins revealed that acute-phase response, response to organic cyclic compounds, complement activation classical pathway, and response to lead ion were significantly enriched at week 2 and 4. Another four processes were only enriched at week 8, namely response to oxidative stress, positive regulation of cell proliferation, thyroid hormone generation, and positive regulation of apoptotic process. The PPI network indicated that these differential proteins were biologically connected in CS-exposed rats. Of the 79 differential proteins in CS-exposed rats, 56 had human orthologs. Seven proteins that had changed at week 2 and 4 when there were no changes of pulmonary function and pathological morphology were verified as potential biomarkers for early screening of CS-induced COPD by proteomic analysis. Another six proteins that changed at week 8 when obvious airflow obstruction was detected were verified as potential biomarkers for prognostic assessment of CS-induced COPD. Conclusions These results reveal that the urinary proteome could sensitively reflect pathological changes in CS-exposed rats, and provide valuable clues for exploring COPD biomarkers.

Andrea Cortegiani, Giulia Ingoglia, Mariachiara Ippolito et al.

Abstract Carbapenem-resistant Gram-negative bacteria are frequent causes of sepsis and septic shock in intensive care unit (ICU) and thus considered a public health threat. Until now, the best available therapies consist of combinations of preexisting or new antibiotics with β-lactamase inhibitors (either new or preexisting). Several mechanisms of resistance, especially those mediated by metallo-β-lactamases (MBL), are responsible for the inefficacy of these treatments, leaving an unmet medical need. Intravenous cefiderocol has been recently approved by the American Food and Drug Administration (FDA) and European Medicines Agency (EMA) for the treatment of complicated urinary tract infections and nosocomial pneumonia due to Gram-negative, when limited therapeutical options are available. In addition, its ability to hijack bacterial iron uptake mechanisms makes cefiderocol stable against the whole Ambler β-lactamase inhibitors and increases the in vitro efficacy against Gram-negative pathogens (e.g., Enterobacterales spp., Pseudomonas aeruginosa, and Acinetobacter baumannii). Trials have already demonstrated their non-inferiority to comparators. In 2021, ESCMID guidelines released a conditional recommendation supporting the use of cefiderocol against metallo-β-lactamase-producing Enterobacterales and against Acinetobacter baumannii. This review provides the opinion of experts about the general management of empiric treatment of patients with sepsis and septic shock in the intensive care unit and detects the proper place in therapy of cefiderocol considering recent evidence sought through a systematic search.

Katherin Faviola Moreno Reyes, Félix Dasio Ayala Peralta, Carlos Velasquez Vasquez

La infección por el virus de la inmunodeficiencia humana (VIH) continúa siendo un problema de salud perinatal a nivel global y en nuestro país, por el incremento de contagio en mujeres embarazadas que corren el riesgo para la transmisión vertical del VIH hacia su bebé durante el embarazo, parto y lactancia materna. Diversas publicaciones mencionan que la prevalencia de transmisión vertical del VIH varía según distintos autores entre 3,8% a 17 %. En el Perú se reporta en 4%. Entre los factores de riesgo asociados a transmisión vertical del VIH se mencionan: ausencia de terapia antirretroviral durante la atención prenatal con razón de posibilidades ajustada (ORa) que varían entre 2,41 a 17,20; ausencia de programa de prevención de la transmisión de madre a hijo del VIH con ORa de 4,6 a 40,6; ausencia de control prenatal ORa 4,6; parto domiciliario con ORa de 3,35 a 8,10; parto por cesárea de emergencia con OR de 4,32; ausencia de profilaxis antirretroviral al recién nacido ORa de 3,4 a 5,83 y alta carga viral en el embarazo entre  4,0 % a 8,5%.

Qiu‐Lin Wang, Ting‐Ting Li, Chang‐Le Fang et al.

Abstract This study aimed to explore the possible target and mechanism of the wheel treadmill (WTM) test for motor function recovery of spinal cord injury (SCI). Rats were divided into sham, control and WTM groups to establish an SCI mode. Rats in the WTM group were trained on the WTM test, and Basso–Beattie–Bresnahan (BBB) scores were determined. The samples were collected, and mRNA sequencing was conducted to determine the changes in gene expression. The coexpressed genes were screened to construct a protein–protein interaction (PPI), followed by the Kyoto Encyclopedia of Genes and Genomes pathway and Gene Ontology function enrichment analysis, and the differentially expressed genes (DEGs) volcano map and hub gene expression heat map were constructed using R language. The BBB scores in the control and WTM groups increased with time, with the WTM group scoring higher than the control group. The results of rat spinal cord tissue sequencing showed that a total of 1679 DEGs were screened in the sham and control groups; 928 DEGs and 731 overlapping genes were screened in the WTM and control groups. The key genes were identified by PPI analysis. One hundred and thirty‐three genes were found to be overlapping by combined analysis of spinal cord sequencing data and BBB scores of rats at Week 7. The top 10 DEGs from high to low were Tyrobp, Rac2, Cd68, C1qb, Aif1, Cd74, Spi1, Fcer1g, RT1‐DA, and Ccl4. The terms with the highest enrichment scores were microglia‐mediated positive regulation of cytotoxicity and major histocompatibility complex class II protein complexes. Treatment with the WTM test promotes recovery of motor function after SCI in rats by modulating intercellular communication and immune function.

Lađević Nebojša, Jovanović Vesna, Jovičić Jelena et al.

Cancer pain remains a significant clinical problem worldwide. Cancer pain causes are multifactorial and complex and varying with a variety of factors and processes related both to the tumor process and to the host itself. Even though the quality of pharmacologic pain management has improved in the last decades, 1 in 3 patients do not receive pain medication appropriate for the intensity of experienced pain. Chronic cancer pain in urologic patients has different traits, since this carcinoma might originate from various organ:, prostate, kidneys, adrenal glands, urinary bladder or the penis. Urogenital neoplasm very often metastasized into the bones (spine, pelvis and head bones) and they are associated with pathological fractures, hypercalcemia, and neurological deficits, which lead to a significant reduction in quality of life. Pain induced by bone metastases is nociceptive pain, but may also be associated with neuropathic pain if the tumor performs compression or invasion of the nerve, spinal cord or nerve plexus. In 70-90% of urological cancer patients pain can be adequately relieved by consistent adherence to the WHO cancer pain recommendations. However, additional pain relief therapies, such as radiation and psychosocial treatment of these patients have to be considered.

Karen D. Davis

Abstract. Pain, by definition, is a subjective experience, and as such its presence has usually been based on a self-report. However, limitations of self-reports for pain diagnostics, particularly for legal and insurance purposes, has led some to consider a brain-imaging–based objective measure of pain. This review will provide an overview of (1) differences between pain and nociception, (2) intersubject variability in pain perception and the associated brain structures and functional circuits, and (3) capabilities and limitations of current brain-imaging technologies. I then discuss how these factors impact objective proxies of pain. Finally, the ethical, privacy, and legal implications of a brain-imaging–based objective measure of pain are considered as potential future technological developments necessary to create a so-called “painometer test.”

Sriganesh Kamath, Gordon Guyatt

Teijo I. Saari, M. Uusi-Oukari, J. Ahonen et al.

Tamara Rodríguez Bonet, Ana Teresa Echevarría Hernández, Ángel Arpa Gámez et al.

<span style="font-family: Verdana,Arial,Helvetica,sans-serif; font-size: small;"><strong>Introducción: </strong> los pacientes que padecen el Síndrome Metabólico, enfrentan el desafío anestésico quirúrgico en condiciones particulares y se encuentran poco documentadas en la literatura médica revisada. <br /> <strong>Objetivo: </strong> determinar la relación entre el Síndrome Metabólico y la aparición de complicaciones cardiovasculares perioperatorias durante la colecistectomía laparoscópica. <br /> <strong>Métodos: </strong> la selección de la muestra se realizó de forma sistemática en el Hospital “Dr. Luis Díaz Soto” desde mayo de 2011 hasta mayo de 2013 y se conformó por 114 pacientes con edades entre 30 y 65 años divididos en tres grupos: Grupo l: compuesto por 38 pacientes portadores de Síndrome Metabólico; Grupo ll: 38 pacientes obesos y Grupo lll: 38 pacientes hipertensos (sin otros criterios de síndrome metabólico). A los pacientes de todos los grupos se les realizó colecistectomía laparoscópica con anestesia general endotraqueal. Las principales variables analizadas fueron: tensión arterial sistólica, media y diastólica, frecuencia cardiaca y el trazado electrocardiográfico. <br /> <strong>Resultados: </strong> hubo tendencia a la hipertensión perioperatoria y complicaciones tales como: taquicardia sinusal, depresión del ST, hipotensión y trastornos del ritmo en el Grupo I (p&lt; 0,05). <br /> <strong>Conclusiones:</strong> la presencia de Síndrome Metabólico, así como de criterios aislados del mismo (obesidad e hipertensión arterial), contribuye a la aparición de complicaciones cardiovasculares perioperatorias durante la colecistectomía por vía laparoscópica. </span>