Delogu G, Marano M, Marandola M, Ciccioli T, Lombardi A, Costantini D
Istituto di Anestesia e Rianimazione, Università degli Studi di Roma La Sapienza.
Ann Ital Chir. 1996 May-Jun;67(3):405-8; discussion 409.
The objective of this paper was to examine the major anaesthetic problems during transthoracic endoscopic sympathectomy without artificial pneumothorax and to present our experience of 16 cases suffering from Raynaud's disease. For the perioperative management we used a double lumen endo-bronchial tube and balanced anaesthesia (intravenous agents plus isoflurane). Arterial pressure, heart rate, ECG, end-tidal carbon dioxide concentration, SatO2, blood gases and peak inspiratory pressures were monitored. The results showed that no significant changes in these parameters occurred during surgery. Since hypoxaemia is the main problem of the thoracoscopic sympathectomy the A.A. emphasize the necessity to ensure a correct ventilation as well as a haemodynamic stability throughout the procedure. The combination of balanced anaesthesia and double lumen endobronchial intubation seems an advisable method when no artificial pnx is instituted. A close monitoring of the circulatory and respiratory systems is imperative.
本文的目的是探讨无人工气胸的经胸内镜交感神经切除术期间的主要麻醉问题，并介绍我们对16例雷诺病患者的经验。对于围手术期管理，我们使用了双腔支气管内导管和平衡麻醉（静脉用药加异氟烷）。监测动脉压、心率、心电图、呼气末二氧化碳浓度、血氧饱和度、血气和吸气峰压。结果表明，手术期间这些参数无显著变化。由于低氧血症是胸腔镜交感神经切除术的主要问题，作者强调在整个手术过程中确保正确通气以及血流动力学稳定的必要性。当不进行人工气胸时，平衡麻醉和双腔支气管内插管相结合似乎是一种可取的方法。必须密切监测循环和呼吸系统。
