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Laparoscopic Surgery

Anesthesia for laparoscopic procedures is a bit challenging for the anesthesiologist of general anesthesia for classical surgery, because it is in the changed conditions are unphysiological for the patient ...



Laparoscopic surgery or minimally invasive surgery appeared back as 1970. in gynecology, and 1987th The first underwent laparoscopic gallbladder removal surgery. Extremely well-accepted method of patients, but the doctor has become a standard in surgery. Initially only selected patients had the opportunity to be subjected to this new surgery technique, and today, 20-odd years later, few are those who operate the classical. Certainly, this has contributed to the modern anesthetic techniques, which virtually every patient could be successfully anesthetized and subjected to changes over into the non operation. First, the abdominal cavity, at the beginning of the operation, the inflated gas CO2 to the abdomen, the surgeon had greater leeway and better visibility of organs. This phenomenon is called the pneumoperitoneum and the result is an increase in abdominal pressure, which can affect blood flow through the internal organs, especially kidneys and liver. Second, pressure on the stomach can cause a return of gastric juice in the mouth and into the trachea and lungs, which would be disastrous for the patient. Thirdly, the position during surgery is either up or down with the upper body, so that there is a change in breathing and circulation. The task of the anesthesiologist is to his knowledge and technique compensates for disturbances that can occur in the body. First of all, the choice of anesthetics and anesthesia forms. In laparoscopic surgery, only comes into consideration general anesthesia, the patient completely relaxed. Besides it is easier for the surgeon, thus allowing the anesthetist to alter the intensity and number of breaths in and out patient enough to keep the lungs inflated to prevent postoperative pulmonary complications. Furthermore, the anesthesiologist must monitor the concentration of CO2 in the blood during surgery because the gas is absorbed from the stomach into the bloodstream. High concentrations of CO2 causes acidosis, acidic condition and is potentially lethal. The anesthetist monitored every second heart beat and blood pressure, oxygen and CO2 concentration, the amount of air into the lungs and lung expansion, the concentration of anesthetic gases in the body. All these parameters must be within normal limits. Although most people today can easily submit to such changes, because laparoscopic surgery are truly elegant and short duration, there is a group of patients who can not undergo these procedures. This refers to patients who suffer from serious kidney, liver or lung disease, in whom pneumoperitoneum might have been very damaging. Anaesthesia for laparoscopic procedures is a bit challenging for the anesthesiologist of general anesthesia for classical surgery, because it is in the changed conditions are unphysiological for the patient. Development of surgery can not be imagined without anesthesia, which accompanies it. Although in the shadow of surgery, anesthesia is one of a profession that has experienced a great boom in the last years of the 20th century, the introduction of improved and safer anesthetics, not to mention the excellent opportunities monitoring. It should be noted that after laparoscopic surgery the patient not only has much less need for analgesics, but they quickly return to normal activities. And here is the important role of the anesthesiologist, to reduce postoperative pain, nausea and vomiting. There are drugs that block these extraordinarily unpleasant side effects, and of which more patients should not suffer. Anesthesia is now added to the term peri-operative medicine, because it cares for the patient before, during and after surgery. Minimally invasive procedures require careful and maximum surgeon and anesthesiologist that the patient had a brief and up to a pleasant stay in the hospital.




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