KMID : 0356920100590020099
|
|
Korean Journal of Anesthesiology 2010 Volume.59 No. 2 p.99 ~ p.103
|
|
Anesthetic management of video-assisted thoracoscopic surgery (VATS) in pediatric patients: the issue of safety in infant and younger children
|
|
Byon Hyo-Jin
Lee Ji-Won Kim Jong-Kuk Kim Jin-Tae Kim Young-Tae Kim Hee-Soo Lee Sang-Chul Kim Chong-Sung
|
|
Abstract
|
|
|
Background: The purpose of this study was to assess the safety issues concerning anesthetic management of video-assisted thoracoscopic surgery (VATS) in pediatric patients.
Methods: The medical records of 52 pediatric patients undergoing VATS using general anesthesia and one-lung ventilation (OLV) were reviewed. OLV was achieved with a Fogarty catheter (n = 23) or endobronchial intubation (n = 7) in patients < 10 years of age (group Y, n = 30), and using a double-lumen tube (n = 19) or a univent (n = 3) in children aged between 10 and 16 years of age (group O, n = 22). Hypoxemia, hypercarbia, the difference between ETCO2 and PaCO2, and the effect of CO2 insufflation were assessed.
Results: A decrease in SpO2 less than 90% was observed in 40% of the group Y, compared to none of the group O (P < 0.05). A hypercarbia (ETCO2 > 50 mmHg) was observed more frequently in group Y (40%) than in group O (0%; P < 0.05). The difference between the ETCO2 and PaCO2 was 10.4 ¡¾ 8.9 mmHg in group Y and 4.6 ¡¾ 3.9 mmHg in group O (P < 0.05). Hypercarbia and acidosis occurred more frequently in patients with CO2 insufflation than those without insufflation in group Y.
Conclusions: Although the anesthesia for VATS in pediatric patients was successfully accomplished, the infants and younger children presented with more intra-operative problems when compared with older children. The anesthetic management for VATS in infants and younger children requires careful and vigilant monitoring.
|
|
KEYWORD
|
|
Children, One lung ventilation, Video-assisted thoracoscopic surgery
|
|
FullTexts / Linksout information
|
|
|
|
Listed journal information
|
|
|