CARDIORESPIRATORY CHANGES DURING LAPAROSCOPIC FUNDOPLICATION IN CHILDREN

The results of a prospective assessment of cardiorespiratory changes r elated to anaesthesia and laparoscopic Nissen fundoplication are descr ibed in 25 children aged 1.2 to 14.3 years, weighing 9.0 to 64.0 kg. R espiratory disease or oesophagitis were present in 68% cases. During b alanced inhalational anaesthesia, hypotension or bradycardia occurred prior to peritoneal insufflation in three cases of reverse Trendelenbu rg position. During surgery, intra-abdominal pressure was in the 6-10 mmHg range. Transiently, two patients were hypotensive while ten were hypertensive. PETCO(2) gradually increased but only two patients requi red increased minute ventilation. One bronchial intubation episode dev eloped. Airway complications were related to isoflurane administration . Postoperatively, transient hypoxia (25% cases) was observed during t he first 3 h. Analgesia duration was in the 40-1440 min range. Hospita l stay was 5.6 +/- 1.5 days (mean +/- SD). Laparoscopic paediatric fun doplication is safe when hypovolaemia and postoperative hypoxia are pr evented.