| Cardiovascular and respiratory changes in children during diagnostic laparoscopy and laparoscopic surgery. |
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Jin Hun Chung, Ki Ryang Ahn, On Sub Shin, Chun Sook Kim, Kyu Sik Kang, Sie Hyeon Yoo, Ji Won Chung, Ja Ug Koo, Jeong Seok Lee |
1Department of Anesthesiology and Pain Medicine, Soonchunhyang University Hospital, College of Medicine, Soonchunhyang University, Cheonan, Korea. ahnkiry@schca.ac.kr
2Department of Anesthesiology and Pain Medicine, Soonchunhyang University Hospital, College of Medicine, Soonchunhyang University, Bucheon, Korea. |
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| Abstract |
BACKGROUND
Information concerning the cardiopulmonary effects of pneumoperitoneum in children is lacking.
METHODS
Twenty eight patients were assigned to receive diagnostic laparoscopy (n = 12) or laparoscopic surgery (n = 16). Before insufflation of CO2, tidal volume was set at 10 ml/kg and respiratory rate was adjusted to achieve an end-tidal CO2 (P(ET)CO2) of 30-35 mmHg. Abdominal pressure was maintained at 10-15 mmHg by a CO2 insufflator. We measured the changes of systolic arterial pressure (SAP), heart rate (HR), P(ET)CO2 and peak airway pressure (PAP) at 5 min before (control value) and after CO2 insufflation and 5 min after CO2 deflation.
RESULTS
SAP and PAP were increased significantly after pnemoperitoneum compared with the control both in diagnostic laparoscopy and laparoscopic surgery (P < 0.05). P(ET)CO2 was increased significantly after pneumoperitoneum and after CO2 deflation in laparoscopic surgery compared with the control and also with diagnostic laparoscopy (P < 0.05).
Driving pressure (the difference between peak airway pressure and abdominal pressure) was increased significantly after pneumoperitoneum in laparoscopic surgery compared with diagnostic laparoscopy (P < 0.05).
CONCLUSIONS
SAP, PAP and P(ET)CO2 increases during diagnostic laparoscopy and laparoscopic surgery, but this effect appears to be of smaller magnitude in diagnostic laparoscopy compared to laparoscopic surgery. We found that these changes had no clinically deleterious effects in healthy children. |
| Key Words:
Airway pressure; Cardiopulmonary effects; End-tidal CO2; Laparoscopy; Pediatric |
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