Anaesthetic implications of thoracoscopic surgery in children

As the equipment and technique have improved, minimally invasive surgery is being applied to younger and younger children. With the advent of this val uable surgical technique, there are also specific modifications necessary i n the anaesthetic technique. When considering the anaesthetic implications of those patients, one must account for both the patient's underlying statu s as well as physiological derangements induced by the surgical procedure. The following article attempts to address and review the specific anaesthet ic implications of thoracoscopic procedures in neonates, infants, and child ren including the preoperative evaluation, intraoperative care and monitori ng, and postoperative issues including analgesia. The techniques of one-lun g anaesthesia, commonly required for thoracoscopy, are reviewed as well as consideration of the adverse effects which can occur during thoracoscopy in cluding inadvertent intravascular CO2 embolism.