title: [Effects of carbon dioxide insufflation on regional cerebral oxygenation during laparoscopic surgery in children: a prospective study].
abstract: OBJECTIVE
  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 (PETCO2), 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), 15min after start of surgery (T1), 30min after start of surgery (T2), 45min after start of surgery (T3), 60min 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.
authors.affiliation: Departamento de Anestesiologia, Faculdade de Medicina, Universidade Sakarya, Sakarya, Turquia. Electronic address: aycatas@yahoo.com.
authors.forename: Ayca Tas
authors.initials: AT
authors.lastname: Tuna
authors.affiliation: Departamento de Cirurgia Pediátrica, Hospital de Ensino e Pesquisa Konya, Konya, Turquia.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Akkoyun
authors.affiliation: Departamento de Anestesiologia, Hospital Infantil e Maternidade Dr Faruk Sukan, Konya, Turquia.
authors.forename: Sevtap
authors.initials: S
authors.lastname: Darcin
authors.affiliation: Departamento de Anestesiologia, Hospital de Ensino e Pesquisa, Universidade Sakarya, Sakarya, Turquia.
authors.forename: Onur
authors.initials: O
authors.lastname: Palabiyik
keywords: Anestesia pediátrica; Carbon dioxide insufflation; Insuflação de dióxido de carbono; Laparoscopia; Laparoscopy; Oxigênio cerebral regional; Pediatric anesthesia; Regional cerebral oxygen