Effects of Pneumoperitoneum during Laparoscopic Surgery in Young Children

Abstract

This observational study of effect of pneumoperitoneum during laparoscopic surgery in 36 patients below 5 years of age (mean age 2.66 ± 1.23 yrs) was carried out in Combined Military Hospital, Dhaka over a period of 2 years. The aim of the study was to evaluate the effects of pneumoperitoneum in this age group. Intraabdominal pressure ceiling was fixed at 12 mm of Hg. Mean duration of pneumoperitoneum was 25 ± 3.21 minutes. Amount of CO2 absorption was assessed by rise of end tidal CO2 (ETCO2) (+21.21%). Effect of pneumoperitoneum and hypercarbia reflected by rise of pulse rate (+16.96%), systolic blood pressure (+12.19%), diastolic blood pressure (+14.58%) and pulmonary airway pressure (+25%). Oxygen saturation reduced a little bit; but came to baseline within a few minute after completion of the procedure. Electrocardiogram showed sinus rhythm in all but one patient. Requirement of postoperative analgesia was minimum. Mean hospital stay was 4±0.21 days. Postoperative side effects or complication was negligible (only two cases of postoperative vomiting). This study supports the safety and better outcome of laparoscopic technique even in young children provided there is good planning and vigilance. Key words: Laparoscopic surgery, pneumoperitoneum, children. DOI: 10.3329/jafmc.v5i2.4577 JAFMC Bangladesh Vol.5(2) (December) 2009, pp.18-20