Anesthesia for pediatric laparoscopic cholecystectomy.
We report the general anesthetic events and clinical concerns encountered with a laparoscopic cholecystectomy in a 19-month-old toddler. Carbon dioxide was insufflated to create a pneumoperitoneum, with resulting intra-abdominal pressures ranging from 5 to 11 mmHg. The end-tidal partial pressure of carbon dioxide (PETCO2) rose as high as 48 mmHg (a 10 mmHg increase from baseline), requiring a 68% increase in minute ventilation to achieve preinsufflation values. Careful monitoring of ventilation, PETCO2, and intra-abdominal pressure are recommended for optimal anesthetic management of the pediatric laparoscopic cholecystectomy patient.
Walsh
M T
MT
Department of Anesthesiology, Children's Hospital Medical Center, Akron, OH 44308.
Vetter
T R
TR
D000769:Anesthesia, Inhalation; D000771:Anesthesia, Intravenous; D001279:Atracurium; D002245:Carbon Dioxide; D017081:Cholecystectomy, Laparoscopic; D002769:Cholelithiasis / Q000601:surgery; D006801:Humans; D007223:Infant; D007530:Isoflurane; D008297:Male; D011028:Pneumoperitoneum, Artificial; D013874:Thiopental
D002245:Carbon Dioxide; D001279:Atracurium; D007530:Isoflurane; D013874:Thiopental