Harlid R
Department of Anaesthesia and Intensive Care, Borås Hospital, Sweden.
Eur J Surg Suppl. 1994(572):37-9.
The aim of this paper was to discuss the stress applied to the circulatory and respiratory systems by the combination of general anaesthesia and thoracoscopic sympathectomy and to show the benefits of an intravenous anaesthetic technique together with a single-lumen endotracheal tube as a safe method of anaesthesia for this procedure. In a retrospective study, 125 cases of thoracoscopic sympathectomy were reviewed. The anaesthesia was a totally intravenous technique with propofol, alfentanil, and atracurium and a gas mixture of 40% oxygen in air. The degree of hypoxaemia during inflation of carbon dioxide into the thorax was assessed. The results showed that hypoxaemia caused no problems in any of the patients. Three patients with severe angina pectoris were also studied using the same anaesthetic technique and they showed marked haemodynamic instability throughout the procedure requiring inotropic support. Haemodynamic values obtained through a Swan-Ganz catheter in one patient showed marked changes during the procedure, but values returned to normal after the operation. Although these patients were haemodynamically unstable there was no problem with hypoxaemia.
本文旨在探讨全身麻醉与胸腔镜交感神经切除术联合应用时对循环和呼吸系统施加的应激，并展示静脉麻醉技术与单腔气管内导管相结合作为该手术安全麻醉方法的益处。在一项回顾性研究中，对125例胸腔镜交感神经切除术病例进行了回顾。麻醉采用丙泊酚、阿芬太尼和阿曲库铵的全静脉技术以及空气中40%氧气的气体混合物。评估了向胸腔内注入二氧化碳期间的低氧血症程度。结果表明，低氧血症在任何患者中均未引发问题。还使用相同的麻醉技术对3例严重心绞痛患者进行了研究，他们在整个手术过程中表现出明显的血流动力学不稳定，需要使用正性肌力药物支持。通过一名患者的 Swan - Ganz 导管获得的血流动力学值在手术过程中显示出明显变化，但术后值恢复正常。尽管这些患者血流动力学不稳定，但低氧血症并无问题。
