The application of pressure-controlled ventilation in laparoscopic appendectomy under general anesthesia of laryngeal mask airway in children

ObjectiveTo observe the clinical effects of pressure controlled ventilation(PCV) in laparoscopic appendectomy under general anesthesia of laryngeal mask airway in children.

MethodsFifty-six children aged 2-10 years old treated with laparoscopic appendectomy were randomly divided into the PCV group(group P) and volume-controlled ventilation group(group V).The airway peak pressure(Ppeak), plat pressure(Pplat), mean arterial pressure(MAP), heart rate(HR) and arterial blood gas at different time-points, and leakage rate of laryngeal mask, incidence rate of adverse reactions and postoperative respriatory complications in two groups were observed.

ResultsThere was no statistical significance in the leakage rate of laryngeal mask or rate of flatulence between two groups after pneumoperitoneum(P>0.05).The related complications of respiratory system in two groups were not found within 24 h after operation.The difference of the related complications between two groups was not statistically significant before pneumoperitoneum(P>0.05).After pneumoperitoneum, the Ppeak, Pplat, PaCO₂, PaO₂ and HR increased significantly, and the MAP decreased significantly in two groups(P < 0.05 to P < 0.01).The Ppeak and Pplat in group V at T2 and T3 were significantly higher than those in group P(P < 0.01), and there was no statistical significance in other indicators between two groups(P>0.05).

ConclusionsPCV can effectively provide the pulmonary ventilation under the relatively low airway pressure, is good for gas exchange, can reduce the effect of CO₂ pneumoperitoneum on respiratory function, has more advantages over the volume-controlled ventilation, especially in general anesthesia of laryngeal mask airway for children.