Vaughan R W
Contemp Anesth Pract. 1982;5:71-94.
Anesthetic management should concentrate on various aspects of pre-, intra-, and postoperative care. Particular laboratory studies, such as arterial blood gases, electrocardiogram, selected pulmonary function tests (e.g., ERV), and serum hepatic profile, can be quite useful. Preoperatively, technical difficulties (intravenous and arterial cannulae, operative positioning, and airway assessment), psychologic considerations, and response to preanesthetic medications can be anticipated. Intraoperative concerns encompass the choice of regional versus general anesthesia, anesthetic biotransformation, and variables influencing intraoperative oxygenation (e.g., effects of general anesthesia, operative position, abdominal packing). Postoperative concerns are directed toward minimizing postoperative hypoxemia, peripheral phlebothrombosis, and fluid imbalances. Special caution is needed in operations subsequent to jejunoileal bypass surgery. Specific choices of anesthetic agents and techniques await further clinical and laboratory investigations in this unique subset of the population.
麻醉管理应专注于术前、术中和术后护理的各个方面。特定的实验室检查，如动脉血气分析、心电图、选定的肺功能测试（如补呼气量）和血清肝功能检查，可能非常有用。术前，可以预测技术难题（静脉和动脉插管、手术体位和气道评估）、心理因素以及对麻醉前用药的反应。术中关注点包括区域麻醉与全身麻醉的选择、麻醉生物转化以及影响术中氧合的变量（如全身麻醉的效果、手术体位、腹部填塞）。术后关注点旨在将术后低氧血症、外周静脉血栓形成和液体失衡降至最低。空肠回肠旁路手术后的手术需要特别谨慎。对于这一独特人群，麻醉药物和技术的具体选择有待进一步的临床和实验室研究。
