DeckerMed Anesthesiology最新文献

Anesthesia for Laparoscopic Surgery: Anesthetic Management and Complications 腹腔镜手术的麻醉:麻醉管理和并发症

DeckerMed Anesthesiology Pub Date : 2022-01-11 DOI: 10.2310/anes.18345

E. Bittner, S. Cao

{"title":"Anesthesia for Laparoscopic Surgery: Anesthetic Management and Complications","authors":"E. Bittner, S. Cao","doi":"10.2310/anes.18345","DOIUrl":"https://doi.org/10.2310/anes.18345","url":null,"abstract":"Laparoscopic surgery results in physiologic changes that encompass multiple organ systems, with respiratory, cardiovascular and neurologic and splanchnic effects. Insufflation of the peritoneum results in reduced lung volumes, atelectasis, and endobronchial migration of the endotracheal tube. Pneumoperitoneum can result in changes to venous return, cardiac output and blood pressure. Hypercapnia due to carbon dioxide gas used in insufflation can reduce cerebral perfusion pressure. Complications during laparoscopic surgery often occur during port placement and creation of the pneumoperitoneum. Problems include injury to blood vessels during trocar entry, vascular injury in the pneumoperitoneum with limited surgical access, severe bradycardia and arrhythmias due to vagal stimulation from peritoneal stretching, subcutaneous emphysema, pneumothorax, gas embolism, and complications associated with steep Trendelenburg positioning. A thorough understanding of the physiologic changes associated with laparoscopic procedures and recognition of potential complications will facilitate in optimal patient care. \u0000\u0000This review contains 4 figures, 1 table and 52 references\u0000Keywords: Laparoscopy; laparoscopic surgery; carbon dioxide; pneumoperitoneum; capnothorax; general anesthesia; subcutaneous emphysema; insufflation ","PeriodicalId":345138,"journal":{"name":"DeckerMed Anesthesiology","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115078133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}