Hemodynamic, Airway Pressure, and Capnometric Changes and Perioperative Outcome in Pediatric Laparoscopic Inguinal Herniorrhaphy: A Comparison with Open Inguinal Herniorrhaphy
Autor: | Nikki Sabharwal, Anoop Raj Gogia, Deepak Bagga, Suniti Kale, Jyoti Garg |
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Jazyk: | angličtina |
Rok vydání: | 2018 |
Předmět: |
Respiratory rate
Hemodynamics laparoscopic 03 medical and health sciences 0302 clinical medicine Pneumoperitoneum 030202 anesthesiology hemodynamic Heart rate Materials Chemistry medicine herniorrhaphy capnometry medicine.diagnostic_test business.industry 030208 emergency & critical care medicine Perioperative medicine.disease Pulse oximetry Blood pressure Airway pressure Anesthesia Original Article business Respiratory minute volume perioperative outcome |
Zdroj: | Anesthesia, Essays and Researches |
ISSN: | 2229-7685 0259-1162 |
Popis: | Background: Laparoscopic procedures which are now established in pediatric population as well exposes the child to supplemental cardiorespiratory changes due to increase in intraabdominal pressure (IAP) and hypercarbia. Aims: This study aims to analyze the effects of pneumoperitoneum and postural modifications on cardiorespiratory system (primary outcome) during pediatric laparoscopic herniorrhaphy (LH) and its comparison with open herniorrhaphy (OH) and assessment of overall perioperative outcome (secondary outcome). Settings and Design: A prospective, observational study conducted in a tertiary care hospital. Materials and Methods: Fifty children undergoing either LH (n = 25) or OH (n = 25) were included in the study. Anesthetic procedure was standardized. Parameters monitored were heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressures (MAP), electrocardiogram lead-II, end-tidal CO2 (ETCO2), airway pressures PPeak, PPlateau, PMean, pulse oximetry, IAP, minute ventilation/respiratory rate alterations. Statistical Analysis Used: Student's t-test and Chi-square test were applied to compare different variables between the two groups. Intragroup analysis was done using the analysis of variance test. Results: The HR was comparable in both groups. The rise in SBP, DBP, and MAP was 9% (102.88 ± 6.91–121.32 ± 6.63), 19% (60.88 ± 4.94–77.00 ± 9.75), and 14.8% (73.92 ± 4.65–90.40 ± 8.42), respectively, in group LH. The rise in peak, plateau, and mean airway pressures was 19.4% (14.20 ± 2.00–18.00 ± 2.54), 20.1% (13.32 ± 1.89–16.89 ± 2.60), and 16.1% (6.20 ± 1.00–7.47 ± 0.96), respectively, in group LH. ETCO2 showed a maximum rise of 19.4% (34.52 ± 3.61–41.21 ± 3.99) in group LH. In laparoscopic group, recurrence was seen in 3 patients. Conclusions: We found significant hemodynamic, airway pressure, and capnometric changes during pediatric LH with comparable perioperative outcome among the two groups. |
Databáze: | OpenAIRE |
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