腹腔镜直肠癌手术的麻醉管理

目的总结腹腔镜直肠癌手术麻醉管理的经验。方法回顾性分析本院2010年2月～2012年2月共40例腹腔镜下直肠癌根治手术的患者麻醉资料，其中28例（57．5％）合并一种或两种全身性疾病，ASAⅠ～Ⅱ级。所有患者均采用气管内插管全身麻醉，术中监测无创血压（BP）、平均动脉压（MAP）、心率（HR）、心电图（ECG）、脉搏血氧饱和度（SpO2）、呼气末CO2分压（PETCO2）。结果气腹后10minMAP、HR、PETC02较气腹前明显升高，经处理，气腹后30minMAP、HR明显降低，PETCO2无明显升高。患者均在手术问拔除气管导管，停止麻醉至拔除气管导管时问5～40min。结论对于腹腔镜直肠癌患者手术的麻醉管理来说，详细的术前访视和全面评估患者，完善围术期监测，加强术中管理，及时纠正处理合并症都是安全的前提和保障。

Anesthesia management during laparoscopic colorectal surgery

Objective To summarize experience in anesthesia management for patients undergoing laparoscopic colorectal surgery.Methods The perioperative data of 40 patients with colorectal carcinoma who underwent laparoscopic surgery in our hospital from February 2010 to February 2012 were analyzed retrospectively.Twenty eight cases(57.5%) of the patients had one or two concomitant systemic diseases,ASAⅠ-Ⅱ.All the patients received general anesthesia with trachealint ubation.Continuous blood pressure(BP),the mean arterial pressure(MAP),heart rate(HR),electrocardiogram(ECG),saturation of pulse oxygen(SpO2),and end-tidal carbondioxide pressure(PETCO2) were monitored during the surgery.Results The mean arterial pressure(MAP),heart rate(HR) and PETCO2 of the patients significantly increased at 10 min after pneumope ritoneum;after adjusting ventilation and giving drugs,MAP and HR decreased significantly,but PETCO2 didn’t change.Extubation was carried out in operating room,the average extubation time was 5-40 min.Conclusion For the anesthetic management of patients with laparoscopic rectal cancer surgery,a detailed preoperative visit and comprehensive assessment of patients,and improving perioperative monitoring,and strengthening the intraoperative management of timely corrective treatment complications are the premise and guarantee of safety.