Anesthetic considerations for endoscopic procedures in children.

The use of laparoscopic and thoracoscopic 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. Significant physiological alterations may occur that are related to patient positioning and the insufflation of air or CO2 into body cavities. Although exceedingly rare, air embolism also may occur during such procedures. An understanding of the anticipated procedure combined with knowledge of its effects on cardiorespiratory function will assist in planning the anesthetic care. This article deals with the specific anesthetic implications of and the cardiorespiratory alterations induced by endoscopic procedures in children.