Anesthetic Management during Laparoscopic Excision of an Urachal Cyst in a Pediatric Patient - A case report -

Abstract

A 14-month-old female patient was admitted for the laparoscopic excision of a complicated urachal cyst. General anesthesia was induced with thiopental and rocuronium and maintained with sevoflurane and the intermittent administration of vecuronium. During the insufflation of her intra-abdominal pressure was maintained below 12 cm to avoid excessive hypercarbia. Thirty minutes after insufflation initiation, end tidal increased to 74 mmHg at a peak inspiratory airway pressure of 24 cm. Laparoscopic excision of the urachal cyst was performed within 2 hours without a further change in end tidal , blood pressure, heart rate, or saturation. Before extubation, saturation by pulse oxymetry was 99% and end tidal was 45-50 mmHg. The patient was discharged without any problem 5 days after the operation. We report on this clinical experience and include a brief review of the literature.