GENERAL-ANESTHESIA USING THE LARYNGEAL MASK AIRWAY DURING BRIEF, LAPAROSCOPIC INSPECTION OF THE PERITONEUM IN CHILDREN

The authors prospectively examined the cardiorespiratory changes seen with general anesthesia using the laryngeal mask with spontaneous vent ilation during brief laparoscopic inspection of the peritoneum in chil dren. Anesthesia consisted of halothane in 50% oxygen/air and a caudal epidural block. The patient was allowed to ventilate spontaneously wi thout assistance. Baseline measurements of heart rate, systolic blood pressure (SBP), end-tidal CO2 (ETCO(2)), tidal volume, respiratory rat e, and oxygen saturation were recorded every 1 min for 5 min prior to the start of laparoscopy and every minute during the laparoscopic proc edure. A total of 15 patients were enrolled in the study ranging in ag e from 15 to 90 months (35.5 +/- 23.8 months) and in weight from 10 to 26.4 kg (14.9 +/- 4.9 kg). The length of the laparoscopy varied from 3 to 9 min (6.1 +/- 2.1 min). Although clinically insignificant, there was an increase in the heart rate from a baseline value of 141 +/- 9 to 148 +/- 9 beats/min (p = 0.0016) and in the SEP from a baseline val ue of 97 +/- 6 mm Hg to 101 +/- 7 mm Hg (p = 0.0087). The baseline tid al volume prior to the start of laparoscopy was 5.2 +/- 1.1 mL/kg and increased to 6.4 +/- 1.4 mL/kg during laparoscopy (p < 0.0001) while t he respiratory rate increased from 32 +/- 4 to 40 +/- 6 breaths/min (p < 0.0001). ETCO(2) increased from a baseline value of 47 +/- 6 to 53 +/- 6 torr (p = 0.0059). The maximum value of the ETCO(2) was 55 torr or greater in 6 patients, exceeded 60 torr in 3 patients, with a maxim um value of 63 torr. The increased ETCO(2) returned to baseline within 2 to 7 min (4.7 +/- 1.5 min) following completion of the laparoscopy. These was no significant change in oxygen saturation. Our initial exp erience suggests that general anesthesia may be provided using the lar yngeal mask during brief laparoscopic inspection of the peritoneum.