Aitkenhead A R
Ann Chir Gynaecol. 1984;73(3):177-82.
The most important complications following gastrointestinal surgery are related to disruption of anastomoses. The fate of a gastrointestinal anastomosis is influenced by many factors. Among these, care in the anaesthetic management and postoperative treatment may reduce the incidence of complications. There are two major directions in which such care may be aimed. The prevention of high intra-luminal pressures and excessive longitudinal traction across anastomoses may be aided by care in the administration of neostigmine, and possibly by the avoidance of morphine for provision of intra-operative and postoperative analgesia. Maintenance of, or improvements in, oxygen supply to an anastomosis may be achieved by avoiding hypoxia, hypocapnia and hypovolaemia, and by the use of regional anaesthetic techniques during surgery and/or in the post-operative period. In addition, sedative and analgesic therapy may influence the incidence of postoperative ileus, and may thus contribute to morbidity.
胃肠手术后最重要的并发症与吻合口破裂有关。胃肠吻合口的愈合受多种因素影响。其中，麻醉管理和术后治疗中的注意事项可降低并发症的发生率。此类注意事项主要有两个方向。新斯的明给药时的注意事项，以及可能避免使用吗啡进行术中及术后镇痛，有助于预防吻合口腔内压力过高和吻合口处过度的纵向牵拉。通过避免低氧血症、低碳酸血症和低血容量，以及在手术期间和/或术后使用区域麻醉技术，可维持或改善吻合口的氧气供应。此外，镇静和镇痛治疗可能会影响术后肠梗阻的发生率，从而影响发病率。
