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Lung compliance during laparoscopic surgery in paediatric patients
Author(s) -
MANNER T.,
AANTAA R.,
ALANEN M.
Publication year - 1998
Publication title -
pediatric anesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.704
H-Index - 82
eISSN - 1460-9592
pISSN - 1155-5645
DOI - 10.1046/j.1460-9592.1998.00699.x
Subject(s) - medicine , insufflation , anesthesia , trendelenburg position , pulmonary compliance , peak inspiratory pressure , propofol , laparoscopic surgery , trendelenburg , airway , respiratory physiology , compliance (psychology) , laparoscopy , tidal volume , respiratory system , surgery , psychology , social psychology
Insufflation of CO 2 and positioning of patients induces changes in cardiovascular and respiratory function during laparoscopic procedures. This study was initiated to assess respiratory mechanics such as lung compliance and peak airway pressure (PIP) during laparoscopic surgery in paediatric patients. Ten consecutive patients (age 1–15 years) scheduled for laparoscopic procedure were included in this open prospective single‐group study. Anaesthesia was induced and maintained with intravenous infusions of propofol and alfentanil. Vecuronium was administered to maintain muscle relaxation. Head down tilt induced a mean decrease of 17% in lung compliance, which was further decreased by 27% from the baseline during insufflation of intraabdominal CO 2 (intraabdominal pressure 12 mmHg). Coincidently, PIP increased by 19% and 32% from the baseline during Trendelenburg position and peritoneal insufflation. Lung compliance and PIP returned to their respective baseline values after removal of CO 2 from the peritoneal cavity. Endtidal CO 2 increased from a baseline value of 4.3 kPa to 5.4 kPa (33–42 mmHg) during surgery when ventilator settings were not altered. We conclude that insufflation of CO 2 induces significant increases in peak airway pressure with simultaneous decreases in lung compliance.