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Thoracoscopy in children: anaesthesiological implications and case reports

A Gentili1, M Lima, R De Rose

  • 1Department of Anestesia, and Intensive Care Antalgic Therapy, University Hospital of Bologna, Policlinico S. Orsola-Malpighi, Bologna, Italy. andrea_gentili@libero.it

Minerva Anestesiologica
|December 13, 2006
PubMed

Insights

Video-assisted thoracic surgery in children is safe and effective, causing minor respiratory, circulatory, and temperature changes. Factors like lung exclusion and procedure length can influence these physiological responses during thoracoscopy.

Area of Science:

  • Pediatric Surgery
  • Thoracic Surgery
  • Anesthesiology

Background:

  • Video-assisted thoracic surgery (VATS) is increasingly utilized in pediatric diagnostics and therapeutics.
  • Understanding physiological changes during VATS in children is crucial for safe practice.

Purpose of the Study:

  • To assess respiratory, cardiocirculatory, and body temperature changes during pediatric thoracoscopy.
  • To identify modifiable factors influencing these physiological trends, including lung exclusion, procedure duration, and preoperative respiratory status.

Main Methods:

  • Analysis of 50 pediatric patients undergoing general anesthesia for diagnostic/therapeutic thoracoscopic procedures.
  • Monitoring of key parameters at six time points: pre-induction, post-positioning, pre-insufflation, during insufflation, pre-deflation, and post-deflation.
  • Comparison of physiological data under different ventilation strategies (one-lung vs. two-lung) and insufflation conditions.

Main Results:

  • Thoracoscopy was well-tolerated with no intraoperative complications.
  • Significant reductions in systolic and diastolic blood pressure and body temperature were observed.
  • Elevated end-tidal CO2 levels were noted during the procedure, influenced by lung exclusion, procedure length, and preoperative respiratory compromise.

Conclusions:

  • Pediatric thoracoscopy induces predictable physiological changes.
  • Despite these changes, the technique is deemed safe and effective for pediatric patients.
  • Monitoring and understanding these changes are vital for optimizing patient management during thoracoscopic procedures.
Abstract

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