Specifics of anesthesiology in laparoscopic surgery in infancy
Pighin, G.; Crozier, T.A.; Weyland, W.; Lüdtke, F.E.; Kettler, D.
Zentralblatt für Chirurgie 118(10): 628-630
1993
ISSN/ISBN: 0044-409X PMID: 8259733 Document Number: 406076
No data exist in the literature pertaining to the problems of laparoscopic surgery in infants and children. However it is reasonable to assume that minimal invasive surgery will find increasing application in these patients in the future. The anesthesiological problems met during surgery are representatively demonstrated and discussed in the context of a case report. It is shown that in infants a reduction of functional residual capacity due to the pneumoperitoneum and consequently increased intraabdominal pressure (IAP) cause alveolar collapse, increased venous admixture and oxygen desaturation more rapidly than in adults. This can be prevented by ventilating with a sufficient level of PEEP. On the other hand, the reduction of venous return caused by increased IAP and aggravated by the necessarily high PEEP can compromise circulation. Adequate volume substitution is essential.