Vogt A, Eberle B
Universitätsklinik für Anästhesiologie und Schmerztherapie, Inselspital, Universitätsspital und Universität Bern, Freiburgstr., 3010 Bern, Schweiz.
Anaesthesist. 2009 May;58(5):520-6. doi: 10.1007/s00101-009-1532-1.
Laparoscopic surgery was introduced into clinical practice in the early 1950s by gynaecologists. Technical improvements allowed its use for more complex and longer lasting procedures. Reduction of postoperative pain, more favourable cosmetic results, quicker recovery and reduced length of hospital stay proved to be advantageous when compared to open surgery. As a result progressively older patients with corresponding pulmonary and cardiovascular comorbidities and morbidly obese patients are now undergoing advanced laparoscopic surgery. Detailed knowledge of the respiratory and hemodynamic pathophysiology induced by capnoperitoneum is necessary to administer safe anaesthesia to such patients. This review addresses the most important effects of capnoperitoneum and recent research as well as the possible implications for clinical practice.
20世纪50年代初，妇科医生将腹腔镜手术引入临床实践。技术的改进使其可用于更复杂、持续时间更长的手术。与开放手术相比，术后疼痛减轻、美容效果更佳、恢复更快以及住院时间缩短都被证明是有利的。因此，现在越来越多患有相应肺部和心血管合并症的老年患者以及病态肥胖患者正在接受先进的腹腔镜手术。要为这类患者实施安全的麻醉，必须详细了解气腹引起的呼吸和血流动力学病理生理学。本文综述了气腹的最重要影响、近期研究以及对临床实践的可能影响。
