A Study Was Carried Out On The Safety Of General Anesthesia Under Different Modes Of Laryngeal Mask Ventilation In Children With Acute Abdomen By Real-time Gastric Ultrasound

Objective:Pediatric acute abdomen is the most common and serious surgical disease in clinic,usually with abdominal distension,abdominal pain,vomiting,diarrhea and other symptoms,mainly including appendicitis,intussusception,incarcerated hernia and other diseases,currently mainly through laparoscopic surgical treatment.Since its introduction into clinical practice in 1983,the laryngeal mask has been widely used as an alternative to a face mask or tracheal intubation during general anesthesia in both adult and pediatric patients.However,the airway anatomy and physiological mechanisms in pediatric patients are very different from those in adults,and the use of a laryngeal mask during ventilation is prone to adverse complications such as displacement,air leakage,and gastric distention.The different modes of ventilation have their advantages and disadvantages,and the pressure-controlled ventilation mode has gradually gained acceptance among clinicians because it provides more stable ventilation pressure and reduces clinical complications,but there are no definite studies to identify which ventilation mode is more suitable for clinical pediatric laparoscopic surgery anesthesia.The objective of this study is to explore the factors contributing to hemodynamics and respiratory dynamics of children undergoing laparoscopic surgery,using gastric ultrasound technology as an aid to evaluate the degree of flatulence,and provide scientific evidence for selecting appropriate ventilation modes during laparoscopic surgery in children.Methods:ASA grade I,60 pediatric patients in our hospital under elective general anesthesia who had laparoscopic appendectomy were randomly divided into pressure control（PCV）mode group P and volume control（VCV）mode group V（n=30）.As part of pediatric laparoscopic surgery’s general anesthesia routine,rapid intravenous induction and 15cmH₂O pressure mask ventilation were performed in both groups.After the laryngeal mask was implanted,both PCV and VCV were conducted.Hemodynamics and respiratory dynamics were measured at several time points,including before anesthesia induction（T0）,immediately after laryngeal mask placement（T1）,10 minutes（T2）,20 minutes,and 30 minutes after placement,as well as immediately after surgery（T5）.Additionally,an ultrasonographic antral cross-sectional area（CSA）was measured before,after,and immediately after anesthesia induction.The occurrence of nausea and vomiting 24 hours after the operation was also monitored.Results showed that at time points T3,T4,and T5.Results:The PIP values in group V were significantly higher than those in group P at time points T3,T4,and T5（P<0.05）,and the differences in Vti,Vte,PIP,Pplat,Cydn,and P_etCO₂at each time point were not statistically significant（P>0.05）;one case of gastric distention rate>10%in group P,one case of gastric distention rate>20%,and two cases of gastric distention rate>10%in group V at T5,and the two groups The difference in the rate of gastric distention between the two groups at this time point is statistically different（P<0.05）;the incidence of postoperative gastric distention and PONV in children in the V group is significantly increased,and the difference is statistically significant（P<0.05）.Conclusion:In this study,the gastric contents were evaluated by ultrasonic technology to explore the differences of different ventilation modes under laryngeal mask ventilation in pediatric acute abdomen surgery,and to provide clinical scientific basis for the selection of appropriate ventilation mode during positive pressure ventilation under general anesthesia laryngeal mask in pediatric acute abdomen surgery.