BACKGROUND: Pneumoperitoneum and head-down tilt during a laparoscopic hysterectomy causes significant alterations in the hemodynamics including decreased cardiac output. The aim of this study was to evaluate the effects of a crystalloid preload on the hemodynamics after a hysterectomy (LAVH).

METHODS: The patients were randomized to receive either no crystalloid fluid preload (control group: 29 women) or 10 ml/kg of a crystalloid fluid preload over 10 min (preloading group: 30 women) before the pneumoperitoneum. The hemodynamic parameters were measured before inducing anesthesia, immediately after the tracheal intubation, before the skin incision, and 2, 5, 10, 20, and 30 min after the pneumoperitoneum with CO₂ with noninvasive cardiac output measurements using the partial CO₂ rebreathing method.

RESULTS: The cardiac index (CI) was reduced 2 and 5 min after the pneumoperitoneum, and then returned to normal. There were no significant differences in the CI after the pneumoperitoneum between the two groups (P<0.05).

CONCLUSIONS: The administration of a 10 ml/kg crystalloid preload did not attenuate the decrease in the CI after pneumoperitoneum.