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S20-6
(P)
COMPARISON OF AIRWAY METHODS AND ANESTHESIA REGIMES IN PEDIATRIC
LAPAROSCOPIC INGUINAL HERNIA SURGERY SURGERY
David Terence THOMAS
1
, Serkan TULGAR
2
, Ibrahim BOGA
2
, Tuba CAN
2
and Kamil Basar GOCMEN
1
1) Pendik State Hospital, Pediatric Surgery, Istanbul, TURKEY - 2) Pendik State Hospital, Anesthesiology and
Reanimation, Istanbul, TURKEY
PURPOSE
Several studies report safe use of laryngeal mask (LMA) in children undergoing laparoscopic surgery. In this study, we
compared different methods of airway devices and anesthesia regimes in children undergoing laparoscopic inguinal
hernia repair.
MATERIAL AND METHODS
Children, aged 1-15y, undergoing unilateral laparoscopic repair for inguinal hernia from August to December 2014 were
prospectively included in this study. Patients were randomised into 4 groups: paralytic dose rocuronium and
endotracheal intubation (ETT) (Gr 1, control), ETT with remifentanil (Gr 2), LMA without muscle relaxant (Gr 3) and LMA
and subparalytic dose rocuronium (gr 4). Insufflation was set at 8mmHg and intragastric pressure (IGP) monitorization
was performed in all patients.
RESULTS
Twenty-eight patients (n=7 each group, average age: 5.5y, weight 19.2kg) were included. Time from beginning of
induction to modified Aldrete score of 9 or above was 41.4m for Gr 1, 29.2m for Gr 2, 33.4m for Gr 3 and 30.5m for Gr
4. Basal Ppeak, end-tidal pCO2 and IGP were similar for all goups. We observed increase in Ppeak and IGP at beginning
of insufflation in all patients in gr 3 and 2 patients in gr 2. Propofol (1mg/kg) was administered to these patients
bringing pressures back to normal. IGP did not increase over 18mmHg in any patient throughout surgery. No surgical,
anesthesiological or hemodynamic complications were observed.
CONCLUSIONS
In children undergoing laparoscopic surgery with low insufflation pressure, anesthesia without nondepolarizing muscle
relaxants or with subparalytic doses with use of LMA for airway management and is safe and effective.