[Laparoscopi Surgery and Anesthetic Management for Infants and Children]

The advantages of laparoscopic surgery resulting in quicker recovery from surgery, decreased postopera- tive pain, shorter hospital stay, and an: improved cos- metic outcome compared to open surgery have led to the expansion of its applications. This expansion includes its use for new surgical procedures as well as indications in younger patients even neonates. The majority of surgical procedures in children are at- tempted under laparoscopy, ranging from short pro- cedures such as day surgeries to even longer case such as congenital biliary atresia. The anesthetic man- agement of laparoscopic surgery in pediatric population has unique features and pitfalls. This chapter de- scribes : (i) the application of laparoscopic surgery for pediatrics ; (ii) the physiological effects of pneumo- peritoneum on respiratory, cardiovascular, renal sys- tems and intracranial pressure ; and (iii) actual anes- thesia management To accomplish safe anesthetic management of the pediatric patients for laparoscopic surgery, anesthesiologists should be familiar with the basic tenets of pediatric anesthesia as well as the potential physiological changes that result from in- creased intra-abdominal pressure due to insufflated CO2, the absorbed CO2, and patient positioning.