小児における腹腔鏡下手術の麻酔

Anesthesiology for Laparoscopic Surgery in Children

　小児における腹腔鏡下手術数は年々増加している．腹腔鏡下手術の特異性，特殊性を考慮した麻酔管理が要求される．われわれは，全身麻酔下にて気管挿管し，調節呼吸としている．二酸化炭素ガスを腹腔内へ注入することで生じる呼吸・循環動態への合併症や，きわめて稀ではあるが重篤になりやすい二酸化炭素塞栓について注意が必要である．

The use of laparoscopic procedures in children continues to increase. Thus, anesthesiologists are faced with an increasing number of children for whom anesthetic care is required during these procedures. We utilize general anesthesia by tracheal tube with controlled ventilation for them. Significant physiological alterations related to the intraabdominal insufflation of carbon dioxide may occur . Although exceedingly rare, carbon dioxide embolism also may occur during such procedures. This article deals with the specific anesthetic implications of and the cardiorespiratory alterations induced by endoscopic procedures in chil-dren.