GENERAL-ANESTHESIA BY MASK WITH SPONTANEOUS VENTILATION DURING BRIEF LAPAROSCOPIC INSPECTION OF THE PERITONEUM IN CHILDREN

We prospectively examined the cardiorespiratory changes seen with gene ral anesthesia by mask with spontaneous ventilation during brief lapar oscopic inspection of the peritoneum in children. Anesthesia consisted of isoflurane in 50% oxygen/air and a caudal epidural block. The pati ent was allowed to ventilate spontaneously without assistance. Baselin e measurements of heart rate, systolic/diastolic blood pressure (BP), end-tidal CO2 (PETCO2), tidal volume, respiratory rate, and oxygen sat uration were recorded every 1 min for 5 min before the start of laparo scopy and every minute during the laparoscopic procedure. A total of 2 0 patients were enrolled in the study, ranging in age from 15 to 80 mo nths (mean 40.8 months) and in weight from 10.5 to 27 kg (mean 15.9 kg ). The length of the laparoscopy varied from 3 to 18 min (mean 6.9 min ). No significant changes (increase or decrease of 20% from baseline) of heart rate or BP occurred. Oxygen saturation remained at 98%-100% t hroughout the procedure in all patients. The baseline tidal volume bef ore the start of laparoscopy was 6.27 +/- 1.9 mL/kg and increased to 7 .3 +/- 2.2 mL/kg during laparoscopy (p = 0.01). The baseline respirato ry rate was 27.7 +/- 7.0 breaths/min and increased to 33.5 +/- 7.2 bre aths/min during laparoscopy (p = 0.0001). PETCO2 increased from a base line value of 37.5 +/- 6.5 to 44.6 +/- 6.8 mm Hg (p = 0.0001). The inc rease in PETCO2 was 10 or greater in 3 patients and exceeded 50 mm Hg in 3 patients, with a maximum value of 66 torr. Our initial experience suggests that general anesthesia may be performed by mask with sponta neous ventilation during brief laparoscopic inspection of the peritone um in children.