Conclusion: Muscle relaxation during laparoscopy for bariatric surgery helps to increase the abdominal volume and therefore the surgical visibility, certainly in a small abdomen. A-127 Is it possible to measure the abdominal pressure-volume relation with three points? J.P. Mulier 1 , S. Van Cauwenberge 2 , B. Dillemans 2 1 Department of Anaesthesiology, 2 Department of Surgery, AZ Sint-JanAV Brugge, Belgium Background and Goal of Study: The abdominal pressure-volume relation (APVR) can be calculated by measuring many pressure-volume points during insufflation. This relation was proven to be linear giving an m and b factor. The APVR might be measured repeatedly during laparoscopy but this takes a lot of work and time. Measuring three points of the relation should be suf- ficient and fast to find the APVR. Goal of this study was to test this hypothesis. Materials and Methods: 10 patients, ASA class I or II, between 21 and 75 years old, without any abdominal intervention and scheduled for a laparoscopic surgery were included in this study with approval from the hospital ethical committee. Anaesthesia was induced with Propofol 200 mg, Sufentanil 20 g, Nimbex 0.2 mg/kg and Sevoflurane 1.5 Mac in a 50% O 2 /N 2 O. Patients were asked to empty the bladder before surgery. The stomach was emptied by suction through a gastric tube. All the CO 2 was allowed to escape after insertion of the trocar. The insufflator Olympus UHI-3 was initialised and a stepwise insuffla- tion at a flow of 1 l/min was given. Measurements were taken every 100 ml till the abdominal pressure reached 15 mmHg. All the CO 2 was then allowed to escape. The insufflator was reinitialised and a high flow insufflation till 7, 11 and 15 mmHg was given. At each pressure set the actual pressure and volume was measured when the flow stopped. The multipoints and the three points measurements were each fitted by a line giving an m, m' and b, b'. The m’s and b’s were compared by a paired t-test. Results and Discussions: No statistical significant difference was found between both groups. Conclusion(s): The APVR can be measured by three points initial and dur- ing the procedure. This allows measurements in all patients and a rapid eval- uation during the procedure. A-128 Abdominal perfusion pressure and intra-abdominal pressure measurements superior to gastric tonometry in prognosing outcome in patients after ruptured abdominal aortic aneurysm repair K. Bieda, P. Sobczynski, R. Szulc Department of Anesthesiology and Intensive Therapy, University of Medical Sciences, Poznan, Poland Background and Goal of Study: Overall mortality in patients admitted to ICU after ruptured abdominal aortic aneurysm (RAA) repair persist high and reach around 30–50%. The aim of this prospective observational study was to evaluate predictive value of abdominal perfusion pressure (APP), intra- abdominal pressure (IAP) and gastric tonometry in patients who underwent RAAA repair. Materials and Methods: We studied 40 consecutive patients of both sexes, mean age 70  10 yrs, presented for RAAA reconstruction. Overall mortality rate was 30% (12 died). IAP, APP (APP = MAP – IAP), splanchnic perfusion parameters (P g CO 2 , P g-a CO 2 ), hemodynamic (CVP, MAP), and laboratory parameters were analyzed every 6 hours for 72 hours postoperatively, starting from admission to the ICU. Results and Discussions: Discriminative value and correlations between analised parameters are shown in tables: APP IAP P g CO 2 P g-a CO 2 AUROC 95% CI 0.673 0.646 0.578 0.583 0.610–0.736 0.592–0.700 0.515–0.641 0.523–0.644 P g CO 2 P g-a CO 2 IAP r = 0.2091 r = 0.013 p  0.0001 p  0.05 APP r =-0.4664 r =-0.3498 p  0.0001 p  0.0001 Conclusion(s): (1) Intra-abdominal pressure measurement is a valuable prognostic param- eter in patients undergoing urgent abdominal aortic surgery. IAP value of 12 mmHg had the greatest sensitivity and specificity to discriminate sur- vivals and nonsurvivals in the studied group of patients. (2) Abdominal perfusion pressure was found to be a superior prognostic parameter compared to IAP. The greatest discriminative power was achieved at the APP value of 70 mmHg. (3) Splanchnic perfusion parameters do not appear to have a reliable prog- nostic value in patients undergoing ruptured abdominal aortic aneurysm repair. However observed correlations between IAP, APP and splanchnic perfusion parameters warrants further studies. A-129 Changes of gastric intramucosal pH in patients undergoing laparoscopic and open cholecystectomy under total intravenous anaesthesia G. Kostopanagiotou, P. Matsota, A. Pandazi, M. Kitsou, C. Batistaki, E. Krepi, I. Grigoropoulou Department of Anaesthesiology, School of Medicine, University of Athens, Attikon Hospital, Athens, Greece Background and Goal of Study: Pneumoperitoneum can cause disturbances in splanchnic perfusion. Gastric intramucosal pH (pHi) reflects splanchnic perfusion, while different anaesthetic agents and changes in end-tidal PCO 2 have been shown that would alter pHi (1, 2). The aim of the study is to compare the effects of laparoscopic cholecystectomy and open cholecystectomy on pHi under standardized anesthesia with total intravenous anesthesia (TIVA) and constant end-tidal PCO 2 . Materials and Methods: Twenty one patients subjected to laparoscopic cholecystectomy (group A) and 21 patients subjected to open cholecystec- tomy (group B) were enrolled in this study. All patients were of ASA I–II, aged 20–60 years and received general anesthesia as TIVA with propofol-remifentanil, while the end-tidal PCO 2 was constant via ventilatory adjustment. pHi was assessed using a tonometric nasogastric catheter. Measurements of pHi were collected at three phases: phase I (after induction of anesthesia before surgical incision), phase II (last stitch) and phase III (15 min after the comple- tion of surgery, patients were full recovered). Results and Discussions: No statistically significant differences of pHi meas- urements were observed between 2 groups at phases I and II, using the equal variance Student t-test. In contrast, at phase III a statistically significant differ- ence was revealed between the two groups (p  0.001), due to a decrease of pHi in the laparoscopic group and a tendency of pHi in open cholecystec- tomy group to return to the baseline values. Besides, pHi decrease in group A was within the normal range. Conclusion(s): Despite inter-group differences in pHi values early postop- eratively, laparoscopic cholecystectomy under TIVA and normocarbia, does not cause significant disturbances in splanchnic perfusion. References: 1 Yagmurdur H, Cakan T, Bayrak A, et al. Acta Anaesthesiol Scand. 2004; 48: 772–777. 2 Thaler W, Frey L, Marzoli GP, et al. Br J Surg. 1996; 83: 620–624. A-130 Two-stage hepatectomy monitored by ICG-densitometry in extended right lobe liver tumors A. Szijarto, B. Hargitai, K. Darvas, P. Kupcsulik Department of Surgery, Semmelweis University, Budapest, Hungary Background: Complete resection of hepatic tumors remains the first choice for curative treatment of primary and secondary liver malignancies. The rea- son for unresectability is that, often, the remnant liver is of insufficient volume to support postoperative liver function. The malfunction is still the principal cause of postoperative death after a major hepatectomy. Various proce- dures have been developed to induce liver regeneration because liver failure is related to the amount of remaining functional liver volume. The aim of the study was to monitor the liver function and the following regeneration by ICG- densitometry. Material and Methods: Data were collected during 3 years from 14 patients with primary (n = 3) or secondary (n = 11) liver tumors who underwent ligation of the right portal branch (first stage) before major liver resection. The median age of the patients was 54 years (range 25 to 72 years); 8 men and 6 women. ICG-densitometry was used to measure the hepatic function. In the pre-, and postoperative periods, US and CT-guided volumetry was performed to esti- mate the liver’s regeneration. Results: Liver resections were performed as a second stage in 8 cases (trisegmentectomy n = 4; right hepatectomy n = 3; non-anatomical resection n = 1). The rest of the patients were unsuitable for liver resection because of postoperative complications. Mortality was nil after the major resections till now. The ICG-densitometry is able to predict the postoperative liver failure Monitoring: equipment and computers 33