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[泌尿外科手术麻醉——机器人辅助前列腺切除术的麻醉]

[Anaesthesia for urological surgery - Anaesthesia for robotic assisted prostatectomies].

作者信息

Börgers André, Brunkhorst Violeta, Groeben Harald

机构信息

Klinik für Anästhesiologie, Intensiv- und Schmerztherapie, Klinken Essen-Mitte.

出版信息

Anasthesiol Intensivmed Notfallmed Schmerzther. 2013 Jul;48(7-8):488-93. doi: 10.1055/s-0033-1352496. Epub 2013 Aug 8.

Abstract

Because of excellent results, high patient satisfaction, and extraordinary surgical conditions robotic assisted prostatectomies have found a wide spread acceptance. Trendelenburg positioning, CO2-Insufflation, and installation of the robot system cause moderate hemodynamic and respiratory changes. Respiration can be compromised by significantly reduced pulmonary compliance during surgery and a marked CO2 load. Therefore, arterial blood gas controls during surgery can be recommended. Over hours edema of head and neck including the upper airways and an increase of the intraocular pressure can develop. There are no restrictions in the choice of the anesthetics. Careful positioning of the patient and critical intravenous fluid management are important determinants of a successful anesthetic management.

摘要

由于出色的手术效果、较高的患者满意度以及卓越的手术条件,机器人辅助前列腺切除术已得到广泛认可。头低脚高位、二氧化碳气腹以及机器人系统的安装会引起中度的血流动力学和呼吸变化。手术过程中肺顺应性显著降低和大量二氧化碳负荷会影响呼吸。因此,建议术中进行动脉血气监测。数小时后,头颈部包括上呼吸道会出现水肿,眼压也会升高。麻醉剂的选择没有限制。患者的精细体位摆放和严格的静脉输液管理是麻醉管理成功的重要决定因素。

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