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KMID : 0356920090560010031
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Korean Journal of Anesthesiology
2009 Volume.56 No. 1 p.31 ~ p.35
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Cardiovascular and respiratory changes in children during diagnostic laparoscopy and laparoscopic surgery
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Chung Jin-Hun
Ahn Ki-Ryang
Shin On-Sub
Kim Chun-Sook
Kang Kyu-Sik
Yoo Sie-Hyeon
Chung Ji-Won
Koo Ja-Ug
Lee Jeong-Seok
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Abstract
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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 (PETCO2) 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), PETCO2 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). PETCO2 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 PETCO2 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. (Korean J Anesthesiol 2009; 56: 31∼5)
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KEYWORD
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Airway pressure, Cardiopulmonary effects, End-tidal CO2, Laparoscopy, Pediatric
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