ANESTHESIOLOGICAL PROBLEMS OF LAPAROSCOPI C SURGERY IN INFANTS

No data exist in the literature pertaining to the problems of laparosc opic surgery in infants and children. However it is reasonable to assu me that minimal invasive surgery will find increasing application in t hese patients in the future. The anesthesiological problems met during surgery are representatively demonstrated and discussed in the contex t of a case report. It is shown that in infants a reduction of functio nal residual capacity due to the pneumoperitoneum and consequently inc reased intraabdominal pressure (IAP) cause alveolar collapse, increase d 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 increase d IAP and aggravated by the necessarily high PEEP can compromise circu lation. Adequate volume substitution is essential.