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Elsa R. Hirvela, MD
Oakland, Calif

Arch Surg. 1998;133:43.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The basis for the current investigation is a previous clinical study by the same authors in which they observed a rise in plasma catecholamine concentrations after the establishment of pneumoperitoneum at 15 mm Hg.¹ The authors are to be commended for their efforts to better characterize this phenomenon using an animal model, but the experimental design ultimately limits the usefulness of the conclusions. The short time spent at each pressure gives little time for equilibration, and the technique of stepping up from 10 mm Hg to 20 mm Hg after a 5-minute interval does not simulate clinical practice. The authors neglect to mention the very fine work of Ho and colleagues,² also in a porcine model, which demonstrated significant transperitoneal carbon dioxide absorption, with associated increases in systemic and pulmonary vascular resistance, when measured over 1 hour's time at 15 mm Hg. We are left to . . . [Full Text of this Article]

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