| Anesthetic Management during Laparoscopic Excision of an Urachal Cyst in a Pediatric Patient: A case report. |
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Jang Hee Lyu, Kyoung Min Lee, Seung Yun Lee, Jun Geol Lee |
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Department of Anesthesiology and Pain Medicine, Konkuk University School of Medicine, Seoul, Korea. kyoungmlee@kuh.ac.kr |
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| Abstract |
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A 14-month-old female patient was admitted for the laparoscopic excision of a complicated urachal cyst. General anesthesia was induced with thiopental and rocuronium and maintained with sevoflurane and the intermittent administration of vecuronium. During the insufflation of CO2 her intra-abdominal pressure was maintained below 12 cmH2O to avoid excessive hypercarbia. Thirty minutes after CO2 insufflation initiation, end tidal CO2 increased to 74 mmHg at a peak inspiratory airway pressure of 24 cmH2O.
Laparoscopic excision of the urachal cyst was performed within 2 hours without a further change in end tidal CO2, blood pressure, heart rate, or O2 saturation. Before extubation, O2 saturation by pulse oxymetry was 99% and end tidal CO2 was 45-50 mmHg. The patient was discharged without any problem 5 days after the operation. We report on this clinical experience and include a brief review of the literature. |
| Key Words:
hypercarbia; intra-abdominal pressure; laparoscopic excision; urachal cyst |
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