Optimizing Anesthetic Management for Laparoscopic Surgery: A Comprehensive Review

被引:1
作者
Radkowski, Pawel [1 ,3 ]
Oniszczuk, Hubert [4 ]
Opolska, Justyna [1 ]
Klosinska, Aleksandra [1 ]
Dabdoub, Tariq [1 ]
Onichimowski, Dariusz [1 ,2 ]
机构
[1] Univ Warmia & Mazury, Fac Med, Dept Anesthesiol & Intens Care, Coll Medicum, Olsztyn, Poland
[2] Reg Specialist Hosp Olsztyn, Dept Anaesthesiol & Intens Care, Olsztyn, Poland
[3] Hosp zum Heiligen Geist Fritzlar, Dept Anaesthesiol & Intens Care, Fritzlar, Germany
[4] Med Univ Bialystok, Fac Med, Bialystok, Poland
来源
MEDICAL SCIENCE MONITOR | 2024年 / 30卷
关键词
Anesthesiology; Cardiovascular System; Central Nervous System; Laparoscopy; Pneumoperitoneum; Ventilation; VOLUME-CONTROLLED VENTILATION; PRESSURE-CONTROLLED VENTILATION; HEART-RATE-VARIABILITY; POSTOPERATIVE NAUSEA; OBESE-PATIENTS; DOUBLE-BLIND; PNEUMOPERITONEUM; PAIN; DEXAMETHASONE; PREVENTION;
D O I
10.12659/MSM.945951
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
Laparoscopy, as the most frequently chosen surgical technique in the world, carries specific complications and distinctions in anesthetic management. Complications of laparoscopy, particularly perceptible as disorders of the physiology of the cardiovascular, respiratory, and nervous systems, are caused by the specific technical conditions required for this type of operation. To facilitate surgical access and to clarify the surgical field, it is necessary to create a splenic emphysema, consisting of filling the peritoneal cavity with carbon dioxide (CO2). This results in an increase in intra-abdominal pressure (IAP) and increased diffusion of CO2 into the blood, causing a state of hypercarbia. The impact of these disturbances is of great importance in the pathological functioning of the above-mentioned organ systems. The anesthetist, in addition to the need to induce a state of general anesthesia, must be aware of and understand the pathological impact of increased intracranial pressure (ICP) and hypercarbia to adjust patient monitoring accordingly and implement appropriate treatment targeting the specific complications occurring during laparoscopy. Complications and contraindications important from the anesthetist's point of view are also described. The 51 articles and reference texts were used for this purpose, which, combined with the authors' knowledge and experience, is intended to be a valuable resource for use by anesthesiology staff. This article aims to explain the effects of laparoscopy on human physiology and to compare and contrast methods of airway management, mechanical ventilation, the type of muscle relaxation used, and postoperative management in patients undergoing laparoscopic surgery.
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页数:11
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