Effects of carbon dioxide insufflation on regional cerebral oxygenation during laparoscopic surgery in children: a prospective study

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• 作者：Ayca Tas Tuna^a ; ^{aycatas@yahoo.com" class="auth_mail" title="E-mail the corresponding author} ; Ibrahim Akkoyun^b ; Sevtap Darcin^c ; Onur Palabiyik^d
• 关键词：Pediatric anesthesia ; Carbon dioxide insufflation ; Regional cerebral oxygen ; Laparoscopy
• 刊名：Brazilian Journal of Anesthesiology (English Edition)
• 出版年：2016
• 出版时间：May-June 2016
• 年：2016
• 卷：66
• 期：3
• 页码：249-253
• 全文大小：310 K

文摘

Laparoscopic surgery has become a popular surgical tool when compared to traditional open surgery. There are limited data on pediatric patients regarding whether pneumoperitoneum affects cerebral oxygenation although end-tidal CO₂ concentration remains normal. Therefore, this study was designed to evaluate the changes of cerebral oxygen saturation using near-infrared spectroscope during laparoscopic surgery in children.

Methods

The study comprised forty children who were scheduled for laparoscopic (Group L, n = 20) or open (Group O, n = 20) appendectomy. Hemodynamic variables, right and left regional cerebral oxygen saturation (RrSO₂ and LrSO₂), fraction of inspired oxygen, end-tidal carbon dioxide pressure (P_ETCO2), peak inspiratory pressure (Ppeak), respiratory minute volume, inspiratory and end-tidal concentrations of sevoflurane and body temperature were recorded. All parameters were recorded after anesthesia induction and before start of surgery (T0, baseline), 15 min after start of surgery (T1), 30 min after start of surgery (T2), 45 min after start of surgery (T3), 60 min after start of surgery (T4) and end of the surgery (T5).

Results

There were progressive decreases in both RrSO₂ and LrSO₂ levels in both groups, which were not statistically significant at T1, T2, T3, T4. The RrSO₂ levels of Group L at T5 were significantly lower than that of Group O. One patient in Group L had an rSO₂ value <80% of the baseline value.

Conclusions

Carbon dioxide insufflation during pneumoperitoneum in pediatric patients may not affect cerebral oxygenation under laparoscopic surgery.