Cerebral oximetry and laparoscopic surgery

Effects of carbon dioxide insufflation on regional cerebral oxygenation during laparoscopic surgery in children: a prospective study

“…9 According to our results, we found no difference in reduction of rSO 2 between laparoscopy and open surgery.…”

“…12 An rSO 2 value <80% of the baseline or rSO 2 <50% were associated with a higher incidence of cerebral ischemia, postoperative cognitive dysfunction and longer hospital stays. 2,11,13 Additionally, if the baseline is lower than 50%, the critical threshold should be reduced to 15%. 11 In the present study, one patient had an rSO 2 value <80% of the baseline at the fortieth min of surgery during pneumoperitoneum.…”

“…De Waal et al demonstrated that insufflation of CO 2 at low IAPs (≤8 mmHg) in children causes considerable increases in P ETCO2 and arterial CO 2 pressure (PaCO 2 ) that are reflected in increases in rSO 2 Data are mean ± SD or n.…”

“…1,2 The successful application of laparoscopic techniques in adults has led to their increasing use in pediatric surgery. 3,4 An investigation in adult patients has shown that although relatively uncommon, significant changes in cerebral oxygenation occur in some patients during CO 2 insufflation for laparoscopic surgery.…”

Laparoscopy in children and its impact on brain oxygenation during routine inguinal hernia repair

“…[1234] The main advantages of laparoscopic surgery are a less post-operative pain, reduced wound complications, minimal scarring, a shorter hospital stay and an earlier return to normal activities including feeding and bowel movements, and return to school, when compared to traditional open surgery. [1234] However, the procedure requires insufflation of the peritoneal cavity with an inert gas; the most commonly carbon dioxide (CO 2 ). Although CO 2 is generally accepted as the optimal gas for insufflation, increases in PaCO 2 and resultant alterations in cerebral blood flow (CBF) may occur.…”