Effects Of Laparoscopic Surgery On Respiratory And Circulatory System In Neonates

Objective:Laparoscopic development has more than 100 years of history and gradually reach the glorious era.With the continuous improvement of imaging technology and operating equipment,the accumulation of surgical experience,training methods are constantly updated and standardized,the growing application of laparoscopy in the surgical field,and gradually break the age limit,started to be applied in the newborn.However,due to the unique characteristics of the disease and the characteristics of different tissues and organs,the safety of laparoscopic operation is often faced with many difficulties.This article to evaluate the effect of CO2 pneumoperitoneum on perioperative rspiratory,circulatory and base-acid in infants during laparoscopic surgery.In this study,we also explore safety and feasibility of laparoscopic surgery in neonates.Methods:25 infants with congenital duodenal obstruction aged 1 hour-28 days old undergoing laparoscopic surgery were chosen,the operation time in 40 to 90 minutes. Pet CO2, Paw,SpO2,DBP, SBP, MAP and HR were measured before pneumoperitoneum(T0), 15min(T1),30 min(T2) after the abdomen was insufflated,and 15min(T3) after CO2 was stopped.In addition,arter blood was collected for blood gas analysis,detedminated PH, PaO2, PaCO2,SaO2 and SBE.Results:Before pneumoperitoneum,respiratory and blood indicators of all patients were in the normal range.Pet CO2,PaW and HR increased as the abdomen was insufflated and PetCO2,PaW were significantly higer than those before insufftion(P<0.05),HR had no significant change(P>0.05),children before and after pneumoperitoneum SPO2,SBP, DBP,MAP is no statistically significant difference(P>0.05);PetCO2 at T3 was significantly decreased,compared wih T0,it is statistically significant(P<0.05),other monitoring data were not statistically significant(P>0.05).The blood gas analysis results showed that the pH,PaO2, PaCO2,SBE at T1,T2 the value has changed,and compared to T0,the pH, PaO2,PaCO2 were statistically significant(P<0.05) and SBE no statistical significance(P>0.05),children before and after pneumoperitoneum SaO2,is no statistically significant difference(P>0.05). At(T3) pH has apparently recovered,compared wih T0,it is statistically significant(P<0.05),other monitoring data were not statistically significant(P>0.05).Conclusions:Pneumoperitoneum with carbon dioxide influnce significantly rspiratory,circulatory and base-acid in infants during the laparoscope surgey,may affect the respiratory mechanics, hemodynamics changes of infants and cause hypercapnia.In operation,the parameters of breath should be adjusted according to PetCO2,strengthening the anesthetic management and precise operation,try to shorten the time of surgery and pneumoperitoneum,laparoscopic operation in infants with duodenal obstruction is still safe and feasible.