Abstract
The paediatric laparoscopic surgery has gained popularity due to reduced morbidity, mortality and health care costs. However, the intra-abdominal pressure (IAP) and higher vagal tone are critical determinants of cardiovascular stability and its anaesthetic management during laparoscopy. Paediatric laparoscopic procedures are likely to cause an increase in pulmonary and systemic vascular resistance, sudden bradycardia during pneumoperitoneum because peritoneal stimulation by a blast of insufflated gas or penetration by trocars and laparoscopes. The present study was designed to quantify the changes in haemodynamics and compare these with conventional abdominal surgery.
Keywords and Abbreviation: Oxygen Saturation, Intra-abdominal pressure, Systemic vascular resistance, Cardiac index, End tidal carbon-dioxide, Partial pressure of venous carbon-dioxide.
References
- Kelling G: ZurCoelioskopie. Arch KlinChir 1923; 126: 226-229.
- SA Sgambati& GH Ballantyne. Minimally Invasive Surgery for diseases of the colon & rectum: the legacy of an ancient tradition. In: Rama M. Jager, M.D. , Ph.D. & Steven Wexner, M.D. Laparoscopic Colectomy, Churchill & Livingstone. New York. 1995. Pp 13-23.
- SL Gans, G Berci. Peritoneoscopy in Infants and Children. Journal of Pediatric. Surgery.1973:8(3):399-405 [PubMed] PMID: 4268498 http://dx.doi.org/10.1016/0022-3468(73)90110-3.
- Ruchi Gupta, Saru Singh. Challenges in Paediatric Laparoscopic Surgeries. Indian Journal of Anaesthesia 2009; 53 (5):560-5I6n6 .[PubMed] PMID: 20640106.
- Bozkurt P, Kaya G, Yeker Y, et al. The cardiorespiratory effects of laparoscopic procedures in infants. Anaesthesia. 1999;54:831–4. [PubMed] PMID: 10460552.
- Sunita goel. Anaesthesia for pediatric laparoscopy. AnestesiaPediatrica e Neonatale. 2006;4(N.1) http://www.anestesiarianimazione.com/2006/01d.asp.
- Jean JL. Anaesthesia for laparoscopic surgery. In: Roy CF, Edward Miller D, Gerald RJ, Michael RF, John SF, editors. Anaesthesia. 5th Edition. California: Churchill Livingstone; 2000. 2140–54.
- Greg Hammer, Steven Hall, Peter J. Davis. Anesthesia for General Abdominal, Thoracic, Urologic and Bariatric Surgery. In: K.M.Etsuro and J.D.Peter editors. Smith’s Anesthesia for Infants and Children, 7th Edition. Pennsylvania : mosbyelsevier. 2006: 686-88
- Timothy BE. Anaesthesia for laparoscopic assisted surgery. In: Thomas HJ, Peter CJ, editors. A practice of anaesthesia. 6th Edition. London: Edward Arnold; 1995. 1391–96.
- Lejus C, Delile L, Plattner V, et al: Randomized, single blinded trial of laparoscopic versus open appendectomy in children. Anaesthesiology. 84(4):801-6.1996 DOI:1097/00000542-199604000-00006
- Stez M, Guerard A, Desruelle P et al: Cardiorespiratory changes during laparoscopic fundoplication in children. PaediatrAnaesth 5: 89, 1995
- Gloria Pelizzo, Aurora Puglisi, Marco Di M, et al: Laparoscopy in infants: Close intraoperative hemodynamic monitoring for patient safety. Journal of Pediatric Endoscopic Surgery; June 2019, Volume 1, Issue 1, 15–22. https://doi.org/10.1007/s42804-019-00004-1.
- Ganneedall P, Odeberg S, Brodin L-A et al : Effects of posture & pneumo-peritoneum during anaesthesia on the indices of left ventricular filling.ActaAnaesthesiolScand 40:160,1996.
- Hsing CH, Hseu SS, Tsai SK, et al: Study to determine the physiological effects of CO2 pneumo-peritoneum during laparoscopy in pediatric patients. Acta anaesthesiol Sin 1995 Mar; 33(1): 1-6. [PubMed : PMID: 7788192]
- Sfez M, Guerard A, Desruelle et al:cardiorespiratory changes during laparoscopic fundoplication in children. Paediatric Anaesthesia 5.89,1995. [PubMed : PMID: 7489430]
- Joris JL, Noirot DP, Legrand MJ, et al. Haemodynamic changes during laparoscopic cholecystectomy. Anaesth Analg 1993:76;1067-1071.
- Odeberg S, Ljungqvist O, Svenberg T et al. Haemodynamic effects of pneumo-peritoneum and the influence of posture during anaesthesia for laparoscopic surgery. Acta AnaesthesiolScand 1994; 38: 276-83
- Ishizaki Y, Bandai Y, Shimomura K, et al. Safe intra-abdominal pressure of carbon dioxide pneumo-peritoneum during laparoscopic surgery. Surgery. 1993; 114 (3):549-554.
- Dexter SP, Vucevic M, Gibson J, et al. Haemodynamic consequences of high- and low-pressure capnoperitoneum during laparoscopic cholecystectomy. Surg Endosc. 1999;13(4):376-381.
- R Sümpelmann, T. Schuerholz, G. Marx et al: Haemodynamic, acid–base and blood volume changes during prolonged low pressure pneumo-peritoneum in rabbits British Journal of Anaesthesia 2006 96(5):563-568.
Corresponding Author
Dr A B Tiwari
Dept of Anaesthesiology, Air Force Hospital, Kanpur, India 208004
DOI: https://dx.doi.org/10.18535/jmscr/v7i7.72
