Povzetek
The development of minimally invasive surgery has revolutionized surgical procedure with its attendant influence on anaesthetic practice. These innovations carry potential risks to the patients, and the anaesthetist’s ability to recognize and harness these challenges to ensure the safety of the patient and the comfort of the surgeon is plausible and an acceptable norm. Thirteen gynaecological cases were selected for demonstration at the University College Hospital Ibadan between 6/11/07 to 15/11/07. All selected patients were American Society of Anaesthesiologists (ASA) physical status 1 and 2 and were scheduled for the operation. The procedure was duly discussed with the patients and consents for both general anaesthesia and the procedure were obtained. General anaesthesia with endotracheal intubation and muscle relaxant technique was preferred and used in all the patients. The following monitoring parameters were utilized; Electrocardiogram (ECG); Non invasive blood pressure (NIBP); pulse oximeter, end tidal C02 (ETCO2 ); temperature; both peripheral and core (hypo pharyngeal) and the patients were mechanically ventilated using the Drager anaesthetic machine with circle breathing systems. Surgery comprised of three diagnostic procedure (3) 23.0% , (adnexial mass (1) -chronic pelvic pain (2)), four hysterectomies 30.8% for dysfunctional uterine, bleeding, myomectomy (4) 30 .0%, Ovarian Cystectomy (2) 15.4%. We had the privilege to conduct anaesthesia for Lift (Gasless) Laparoscopic surgery at the University College Hospital (UCH) Ibadan and would like to share pertinent issues relevant to anaesthesia and about this novel technique.
Keywords: Gasless laparoscopy: anaesthetists..
Résumé
Le développement de la chirurgie invasive minimale a révolutionné la procédure chirurgicale avec sa participation influence par la pratique anesthetique.Ces innovations portent des risques potentiels aux patients et l’habilité de l’anesthésiste a reconnaitre et veiller sur ces défis pour assurer la précaution sur le patient et le confort du chirurgien est une norme acceptable. Treize cas gynécologiques étaient sélectionnés pour cas de démonstration au Centre Hospitalier Universitaire d’Ibadan au Nigeria entre 6/11/07 to 15/11/07. Tous es patients sélectionnés respectaient les critères de statut physique 1 et 2 de la Société Américaine Anesthésiologistes(SAA) et planifies pour une opération. La procédure était pleinement discutée avec le patient et le consentement obtenu. L’anesthésie générale avec une intubation endo-trachéale et une technique de relaxation musculaire était préférée et utilise chez tous les patients. Les paramètres suivant étaient contrôlés ; Electrocardiogramme (ECG); la pression artérielle non-invasive (NIBP); oximetre a pouls, volume tidale finale C02 (VTCO2 ); température peripherale et corporelle (hypo pharyngale) et les patients étaient ventilés de façon mécanique utilisant la machine anesthétique de Drager avec des systèmes cyclique de ventilation. La chirurgie compris trois procédures diagnostique (3) 23.0%, (masse indexicale (1) -douleur chronique pelvienne (2)), quatre hystérectomies 30.8% pour disfonctionnement utérine, saignement, myomectomie (4) 30 .0%, Cystectomie ovarienne (2) 15.4%. Nous Avons eu le privilège de faire l’anesthésie pour la chirurgie laparoscopique sans gaz au Centre Universitaire Hospitalier(UCH) Ibadan et voudrait partager ces issues pertinent a l’anesthesie et la nouvelle technique.
Correspondence: Dr P.T.Sotunmbi, Department of Anaesthesia University College Hospital, Ibadan, Nigeria. Email: sotunmbipt@yahoo.com
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