优化腹腔镜手术的麻醉管理:全面回顾。

IF 3.1 4区 医学 Q1 Medicine
Paweł Radkowski, Hubert Oniszczuk, Justyna Opolska, Aleksandra Kłosińska, Tariq Dabdoub, Dariusz Onichimowski
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引用次数: 0

摘要

腹腔镜手术是世界上最常用的外科技术,具有特殊的并发症和不同的麻醉管理。腹腔镜手术的并发症,特别是心血管、呼吸和神经系统的生理紊乱,是由这种手术所需的特殊技术条件引起的。为了便于手术进入和明确手术区域,有必要制造脾脏气肿,包括向腹腔注入二氧化碳(CO₂)。这将导致腹腔内压(IAP)升高,二氧化碳向血液中的扩散增加,造成高碳酸血症。这些干扰对上述器官系统的病理功能影响极大。麻醉师除了需要诱导全身麻醉状态外,还必须意识到并了解颅内压(ICP)升高和高碳酸血症的病理影响,以便相应地调整对患者的监测,并针对腹腔镜手术中出现的特殊并发症实施适当的治疗。此外,还从麻醉师的角度描述了重要的并发症和禁忌症。为此使用了 51 篇文章和参考文献,结合作者的知识和经验,旨在成为麻醉科工作人员使用的宝贵资源。本文旨在解释腹腔镜手术对人体生理的影响,并比较和对比腹腔镜手术患者的气道管理、机械通气、肌肉松弛类型和术后管理方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Optimizing Anesthetic Management for Laparoscopic Surgery: A Comprehensive Review.

Laparoscopy, as the most frequently chosen surgical technique in the world, carries specific complications and distinctions in anesthetic management. Complications of laparoscopy, particularly perceptible as disorders of the physiology of the cardiovascular, respiratory, and nervous systems, are caused by the specific technical conditions required for this type of operation. To facilitate surgical access and to clarify the surgical field, it is necessary to create a splenic emphysema, consisting of filling the peritoneal cavity with carbon dioxide (CO₂). This results in an increase in intra-abdominal pressure (IAP) and increased diffusion of CO₂ into the blood, causing a state of hypercarbia. The impact of these disturbances is of great importance in the pathological functioning of the above-mentioned organ systems. The anesthetist, in addition to the need to induce a state of general anesthesia, must be aware of and understand the pathological impact of increased intracranial pressure (ICP) and hypercarbia to adjust patient monitoring accordingly and implement appropriate treatment targeting the specific complications occurring during laparoscopy. Complications and contraindications important from the anesthetist's point of view are also described. The 51 articles and reference texts were used for this purpose, which, combined with the authors' knowledge and experience, is intended to be a valuable resource for use by anesthesiology staff. This article aims to explain the effects of laparoscopy on human physiology and to compare and contrast methods of airway management, mechanical ventilation, the type of muscle relaxation used, and postoperative management in patients undergoing laparoscopic surgery.

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来源期刊
Medical Science Monitor
Medical Science Monitor MEDICINE, RESEARCH & EXPERIMENTAL-
CiteScore
6.40
自引率
3.20%
发文量
514
审稿时长
3.0 months
期刊介绍: Medical Science Monitor (MSM) established in 1995 is an international, peer-reviewed scientific journal which publishes original articles in Clinical Medicine and related disciplines such as Epidemiology and Population Studies, Product Investigations, Development of Laboratory Techniques :: Diagnostics and Medical Technology which enable presentation of research or review works in overlapping areas of medicine and technology such us (but not limited to): medical diagnostics, medical imaging systems, computer simulation of health and disease processes, new medical devices, etc. Reviews and Special Reports - papers may be accepted on the basis that they provide a systematic, critical and up-to-date overview of literature pertaining to research or clinical topics. Meta-analyses are considered as reviews. A special attention will be paid to a teaching value of a review paper. Medical Science Monitor is internationally indexed in Thomson-Reuters Web of Science, Journals Citation Report (JCR), Science Citation Index Expanded (SCI), Index Medicus MEDLINE, PubMed, PMC, EMBASE/Excerpta Medica, Chemical Abstracts CAS and Index Copernicus.
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