CARDIORESPIRATORY CHANGES IN CHILDREN DURING LAPAROSCOPY

The authors prospectively examined the cardiorespiratory changes durin g brief laparoscopy (less than 15 minutes) in children. Intraoperative ventilatory management included a tidal volume of 12 mL/kg, with the rate adjusted to achieve an end-tidal CO2 (PETCO(2)) of 30 to 35 mm Hg . The initial rate and tidal volume were not changed during the proced ure. Baseline measurements of heart rate, blood pressure, peak inflati ng pressure (PIP), PETCO(2), and oxygen saturation were recorded every minute for 5 minutes before the start of the laparoscopic procedure, and every minute during the laparoscopic procedure. Fifty five patient s were enrolled in the study (age range, 1 month to 7 years; weight ra nge, 5.2 to 31 kg). PIP increased from the baseline value of 20 rt 2.5 to 23 +/- 3.2 cm H2O (P < .01) during laparoscopy. The increase in PI P was 5 or more in six patients, with a maximum of 7. PETCO(2) increas ed from the baseline value of 32 +/- 3.1 to 35 +/- 4.8 mm Hg (P < .01) . The PETCO(2) returned to baseline within 10 minutes after completion of the laparoscopy. No increase in ventilatory parameters was require d during the brief laparoscopic procedure. Copyright (C) 1995 by W.B. Saunders Company