Objective To explore the association between optimum pneumoperitoneum pressure and surface area of pediatric laparoscopic surgery, and to enhance the surgical safety and reduce intraoperative and postoperative complications related to pneumoperitoneum pressure. Methods Pediatric laparoscopic surgery was performed in 150 children aged 0.5 to 8 years. According to the pneumoperitoneum pressure, 150 patients were equally divided into group A ［(6-8)mmHg, n=50］, group B ［(8.1-10)mmHg, n=50］ and group C ［(10.1-12)mmHg, n=50］. The vital signs, blood gas analysis and clarity of operative field were monitored before and at 30 minutes after pneumoperitoneum establishment. Results Before pneumoperitoneum establishment, there was no significantly difference in SBP, DBP, HR and SpO2 between three groups (P＞0.05). At 30 minutes after pneumoperitoneum establishment, the heart rate, systolic pressure, diastolic pressure, pCO2 and HCO3- increased significantly and pH, pO2 decreased in group C compared with group A and group B (P＜0.05). At 30 minutes after pneumoperitoneum establishment, the clarity of operative field in group B was superior to that in group A and group C (P＜0.05). Pneumoperitoneum pressure was not correlated with surface area, height and weight (P＞0.05). Conclusions The optimum pneumoperitoneum pressure for pediatric laparoscopic surgery is 8 to 10 mmHg. This pneumoperitoneum pressure can satisfy the need of operative field and surgical manipulation, can reduce the impact of CO2 on circulation and breathing, and decrease the occurrence of postoperative complications.

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