Quandt J E
Department of Small Animal Medicine and Surgery, University of Georgia, College of Veterinary Medicine, Athens 30602, USA.
Clin Tech Small Anim Pract. 1999 Feb;14(1):50-5. doi: 10.1016/S1096-2867(99)80027-9.
Laser surgery and laparoscopy are two relatively new surgical techniques gaining popularity in veterinary medicine, which require special consideration when being performed on the anesthetized patient. For laser surgery, consideration must be given to the possibility of atmospheric contamination, inappropriate energy transfer, eye injury, perforation of a vessel or anatomic structure, perforation of the endotracheal tube, and fire. The primary concern with laparoscopy and thoracoscopy is the creation of a pneumoperitoneum or pneumothorax, which can result in (1) hypercarbia and inadequate ventilation, (2) poor cardiac output and systemic blood pressure, and (3) gas embolism. To minimize complications, patients should be placed on positive pressure ventilation, be well hydrated before and during the procedure, and be thoroughly monitored (ECG, capnography, pulse oximetry.
激光手术和腹腔镜检查是兽医医学中越来越受欢迎的两种相对较新的手术技术，在对麻醉患者进行操作时需要特别考虑。对于激光手术，必须考虑到大气污染、能量传递不当、眼损伤、血管或解剖结构穿孔、气管内导管穿孔以及火灾的可能性。腹腔镜检查和胸腔镜检查的主要问题是气腹或气胸的形成，这可能导致：（1）高碳酸血症和通气不足；（2）心输出量和全身血压降低；（3）气体栓塞。为了尽量减少并发症，患者应接受正压通气，在手术前和手术期间充分补液，并进行全面监测（心电图、二氧化碳监测、脉搏血氧饱和度测定）。
