Postprocedural Clinical and Laboratory Evaluation of Sheep Submitted to Different Intrabdominal Pressures During Laparoscopy

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Abstract
The sheep experimental model is increasingly being used in laparoscopy, and there is a need to ensure animal welfare during and after the procedures . Therefore, the present study aims to evaluate postprocedural clinical and laboratory variables of sheep submitted to different intrabdominal pressures during laparoscopy. Ten female nonpregnant healthy adult Santa Ines ewes (48.8 ± 5.6 kg) were randomly submitted to a crossover study using different intrabdominal pressures (IAPs): 0 mmHg (G1), 10 mmHg (G2), 12 mmHg (G3), and 15 mmHg (G4). They were anaesthetised and mechanically ventilated (VT=15 ml.kg−1) with positive end-expiratory pressure (3 cmH2O) and FiO2=1.0. At the same time, pneumoperitoneum was induced and maintained by Hasson's trocar cannula attached to an insufflator with no invasive visceral intervention. Physical examination and malondialdehyde levels were gathered immediately before (T0), 24h (T1), 72h (T2), 7 days (T3) and 14 days (T4) after procedure. Haematology and fibrinogens variables were gathered at T0, T2 and T3, while serum biochemistry at T0 and T2. In the group with 15 mmHg of IAP, fibrinogen levels suggest a late inflammatory response persisted for up to 7 days (from 310±179 to 610±335 mg/dL). Malondialdehyde levels in the pneumoperitoneum persisted in ascending levels for up to 14 days (from 257.2±136.5 to 369.7±201.4 nM/g Hb). White blood cell (WBC), neutrophils, lymphocytes, and N:L ratios increased above normal levels in 72h post-procedure and returned to normal within 7 days, except in the group of 15 mmHg of IAP which the highest value was reached 7 days post-procedure. Alterations in clinical parameters were mild and within normal values for the specie and breed in all groups. Biochemical analysis for all parameters was within the normal range in all groups. Still, monitoring aspartate aminotransferase (AST) up to 7 days after laparoscopic procedures is advisable due to its 72h increase. Although no significant clinical and haematological alterations were observed, biochemical alterations and oxidative stress were greater up to 14 days after the procedure in the group with 15 mmHg IAP.