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目的:探讨儿童腹腔镜手术时CO2气腹对患儿呼吸循环功能的影响。方法:选择静吸复合全麻或静吸复合全麻+硬膜外麻醉;气腹压力1.07～1.87Kpa,流量:2L/min,并根据手术部位﹑年龄﹑体重作适当调整。麻醉诱导后气腹前行过度通气,术中根据气道峰压、EtCO2调整呼吸频率。术中监测EKG、HR、BP、SpO2、EtCO2、尿量。结果:气腹5min后,HR、BP、EtCO2均升高,SpO2没有变化。15min后HR、BP有所下降,EtCO2则保持较高水平。放气后,EtCO2一过性增高,HR、BP略有增高。术中出现皮下气肿1例。结论:CO2气腹对儿童麻醉中呼吸循环功能有一定影响。应防止CO2潴留及高碳酸血症等并发症。
Objective: To investigate the effect of CO2 pneumoperitoneum on respiratory function in children during laparoscopic surgery. Methods: We chose static general anesthesia or static general anesthesia plus epidural anesthesia. The pneumoperitoneum pressure was 1.07 ~ 1.87Kpa, the flow rate was 2L / min, and adjusted according to the surgical site, age and weight. After induction of anesthesia, the pneumoperitoneum was hyperventilated and the intraoperative respiratory rate was adjusted according to the peak airway pressure and EtCO2. Intraoperative monitoring EKG, HR, BP, SpO2, EtCO2, urine output. Results: After pneumoperitoneum 5min, HR, BP, EtCO2 increased, SpO2 did not change. After 15min HR, BP decreased, while EtCO2 maintained a high level. After deflation, EtCO2 transient increased, HR, BP increased slightly. Intraoperative subcutaneous emphysema occurred in 1 case. Conclusion: CO2 pneumoperitoneum has a certain influence on respiratory function in children during anesthesia. Should prevent CO2 retention and hypercapnia and other complications.