Left ventricular regional wall motion abnormalities during pneumoperitoneum in children

Huettemann, Egbert; Sakka, Samir G.; Petrat, G; Schier, Felix; Reinhart, Konrad

doi:10.1093/bja/aeg130

Cited by 32 publications

(17 citation statements)

References 8 publications

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“…The use of minimal pressure nevertheless is advocated because tolerance is unknown above 13 mm Hg, and the stability of the arterial pressure does not exclude alterations of the cardiac output. 24,25 Postoperative hypothermia was frequent and the final temperature was Ͻ35°C in 25% of the infants. The heightened sensitivity to hypothermia in the newborns, caused by an increased caloric loss and a per-operative drop in thermogenesis, was aggravated by the frequently prolonged surgical times and the use of cold and dry gas.…”

Section: Discussionmentioning

confidence: 99%

Tolerance of Laparoscopy and Thoracoscopy in Neonates

et al. 2005

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ABSTRACT. Objectives. Video-surgery in neonates is recent. Data on the respiratory, hemodynamic, and thermic effects during the first month of life are still sparse. This study aimed to evaluate the tolerance of videosurgery in neonates and to determine the risk factors of per-operative complications.Methods. From 1994 to 2004, 49 neonates (mean age: 11 days; weight: 3285 g) underwent 50 video-surgical procedures. Indications for laparoscopy were duodenal atresias, volvulus with malrotation, pyloric stenosis, gastroesophageal reflux, cystic lymphangiomas, ovarian cysts, biliary atresia, and congenital diaphragmatic hernias; indications for thoracoscopy were esophageal atresias and tracheoesophageal fistula.Results. Median operative time was 79 minutes. Mean insufflation pressure was 6.7 mm Hg (range: 3-13). Oxygen saturation decreased, especially with thoracic insufflation or high-pressure pneumoperitoneum. Systolic arterial pressure, which decreased in 20% of the patients, was controlled easily with vascular expansion. Thermic loss (mean postoperative temperature: 35.6°C) was proportional to the duration of insufflation. No surgical incident was noted. Ten anesthetic incidents occurred (20%), 3 of which required temporary or definitive interruption of insufflation (O 2 saturation <70%). Risk factors for an incident were low preoperative temperature, high variation of end-tidal pressure of CO 2 , surgical time >100 minutes, thoracic insufflation, and a high oxygen or vascular expansion requirement at the beginning of insufflation.Conclusion. The neonate's high sensitivity to insufflation is an important limiting factor of video-surgery. ABBREVIATIONS. ETCO 2 , end-tidal pressure of CO 2 ; O 2 sat, oxygen saturation; HR, heart rate; PIP, peak inflating pressure.

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Section: Discussionmentioning

confidence: 99%

Tolerance of Laparoscopy and Thoracoscopy in Neonates

et al. 2005

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“…Huettemann et al found significant septal hypokinesia at an IAP of 12 mmHg in paediatric patients undergoing laparoscopic surgery. 6 In our patient the IAP was kept below 10 mmHg and all the time we did not observe any episode of hypotension or bradycardia throughout the conduct of anaesthesia.…”

Section: Discussionmentioning

confidence: 48%

Anaesthetic management for laparoscopic cholecystectomy in a child

Kumar

Bhattarai

Adhikary

2015

J. Soc. Anesth. Nep.

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Laparoscopic surgical techniques offer several advantages over conventional open surgery. However, anaesthesia for laparoscopic surgical procedures is challenging due to various associated physiological consequences mainly of intra-peritoneal carbon dioxide insufflation and positioning. Gall stone disease is rare in pediatric age group and therefore, experience of anaesthetic management in such a condition is limited. Here we describe anaesthetic management of a 56-month-old male child scheduled for laparoscopic cholecystectomy for gall stone disease.Journal of Society of Anesthesiologists 2014 1(2): 83-85

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“…TULAA and CMLA both require pneumoperitoneum to provide a superior view, but this can sometimes cause a decrease in venous return and hypokinesia of the heart, particularly in children [35][36][37]. TULAA also requires more specialized devices than CMLA, including a peculiar trocar [13,26] and an automatic sewing/ligation device [14][15][16].…”

Section: Discussionmentioning

confidence: 99%