Coe Calvin, Shuttleworth Paul W, Rangappa Deepak, Abdel-Halim Mostafa
General Surgery, Tameside General Hospital, Manchester, GBR.
Anaesthesia, Tameside General Hospital, Manchester, GBR.
Cureus. 2023 Sep 19;15(9):e45529. doi: 10.7759/cureus.45529. eCollection 2023 Sep.
Laparotomy is a surgical incision utilised in both emergency and elective scenarios to gain access to abdominal surgery. General anaesthesia is usually necessitated due to the substantial insult of the approach and to facilitate organ relaxation and paralysis. However, this brings with it the need for an assessment of the suitability of the anaesthetic technique, with a large number of patients having comorbidities significant enough to exclude them from surgery. Locoregional anaesthesia, provided via spinal, epidural, or a combined approach offers a means of providing anaesthesia that places a reduced level of strain on patients' cardiorespiratory function. We review the existing literature on the topic of so-called "awake laparotomy" performed with locoregional anaesthesia and present a case series including both elective and emergency procedures.
剖腹术是一种在急诊和择期手术中都可采用的外科切口，用于进行腹部手术。由于该手术方式对身体的创伤较大，且为了便于器官松弛和麻痹，通常需要全身麻醉。然而，这就需要评估麻醉技术的适用性，因为大量患者存在严重的合并症，足以排除他们进行手术的可能性。通过脊髓、硬膜外或联合方式提供的局部区域麻醉提供了一种麻醉方法，这种方法对患者心肺功能的压力较小。我们回顾了关于采用局部区域麻醉进行所谓“清醒剖腹术”这一主题的现有文献，并呈现了一个包括择期和急诊手术的病例系列。
