Asakawa Makoto
Department of Clinical Sciences, Cornell University College of Veterinary Medicine, VMC Box 35, Ithaca, NY 14853-6401, USA.
Vet Clin North Am Small Anim Pract. 2016 Jan;46(1):31-44. doi: 10.1016/j.cvsm.2015.07.006. Epub 2015 Sep 26.
Anesthesia for endoscopic surgery can be challenging depending on surgical manipulations and patient comorbidity. Anesthetists must understand the possible systemic changes and complications that are associated with endoscopic surgery. Pneumoperitoneum induces vasoconstriction, reduces cardiac output, and decreases functional residual capacity in the cardiopulmonary system. Both hypoventilation caused by the thoracoscopic procedure and CO2 insufflation increase Paco2. To prevent the problems associated with high Paco2, monitoring of end-tidal CO2 (ETco2) and capability of positive pressure ventilation are crucial. Sudden changes of ETco2 should be monitored closely. Endoscopic surgery should be a less invasive procedure; however, appropriate analgesia remains necessary.
根据手术操作和患者合并症的不同，内镜手术的麻醉可能具有挑战性。麻醉医生必须了解与内镜手术相关的可能的全身变化和并发症。气腹会引起血管收缩，降低心输出量，并减少心肺系统的功能残气量。胸腔镜手术引起的通气不足和二氧化碳气腹都会增加动脉血二氧化碳分压（Paco2）。为了预防与高Paco2相关的问题，监测呼气末二氧化碳（ETco2）和正压通气能力至关重要。应密切监测ETco2的突然变化。内镜手术应该是一种侵入性较小的手术；然而，适当的镇痛仍然是必要的。
