Anesthetic management of video-assisted thoracoscopic surgery (VATS) in pediatric patients: the issue of safety in infant and younger children.
10.4097/kjae.2010.59.2.99
- Author:
Hyo Jin BYON
1
;
Ji Won LEE
;
Jong Kuk KIM
;
Jin Tae KIM
;
Young Tae KIM
;
Hee Soo KIM
;
Sang Chul LEE
;
Chong Sung KIM
Author Information
1. Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Seoul, Korea. kimjintae73@hotmail.com
- Publication Type:Original Article
- Keywords:
Children;
One lung ventilation;
Video-assisted thoracoscopic surgery
- MeSH:
Acidosis;
Aged;
Anesthesia;
Anesthesia, General;
Anoxia;
Catheters;
Child;
Humans;
Infant;
Insufflation;
Intubation;
Medical Records;
One-Lung Ventilation;
Thoracic Surgery, Video-Assisted
- From:Korean Journal of Anesthesiology
2010;59(2):99-103
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: The purpose of this study was to assess the safety issues concerning anesthetic management of video-assisted thoracoscopic surgery (VATS) in pediatric patients. METHODS: The medical records of 52 pediatric patients undergoing VATS using general anesthesia and one-lung ventilation (OLV) were reviewed. OLV was achieved with a Fogarty catheter (n = 23) or endobronchial intubation (n = 7) in patients < 10 years of age (group Y, n = 30), and using a double-lumen tube (n = 19) or a univent (n = 3) in children aged between 10 and 16 years of age (group O, n = 22). Hypoxemia, hypercarbia, the difference between ETCO2 and PaCO2, and the effect of CO2 insufflation were assessed. RESULTS: A decrease in SpO2 less than 90% was observed in 40% of the group Y, compared to none of the group O (P < 0.05). A hypercarbia (ETCO2 > 50 mmHg) was observed more frequently in group Y (40%) than in group O (0%; P < 0.05). The difference between the ETCO2 and PaCO2 was 10.4 +/- 8.9 mmHg in group Y and 4.6 +/- 3.9 mmHg in group O (P < 0.05). Hypercarbia and acidosis occurred more frequently in patients with CO2 insufflation than those without insufflation in group Y. CONCLUSIONS: Although the anesthesia for VATS in pediatric patients was successfully accomplished, the infants and younger children presented with more intra-operative problems when compared with older children. The anesthetic management for VATS in infants and younger children requires careful and vigilant monitoring.
