Anaesthesia for robotic-assisted radical prostatectomy: considerations for laparoscopy in the Trendelenburg position
Anaesthesia for robotic-assisted radical prostatectomy: considerations for laparoscopy in the Trendelenburg position
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DOI：
10.1177/0310057x0703500221
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发表时间：
2007-04-01
影响因子：
1.5
通讯作者：
Koh, L. K. D.
中科院分区：
文献类型：
--
作者：
Phong, S. V. N.;Koh, L. K. D.
本文介绍了两例使用da芬奇遥控手术系统进行机器人辅助腹腔镜根治性直肠癌切除术后的麻醉并发症。病例1描述了一名拔管后呼吸窘迫的患者，需要在重症监护室重新插管和随后的通气。这归因于喉部水肿，最可能是由于气腹和长时间极端头低脚高位导致头部静脉流出减少。病例2描述了一名轻度臂丛神经失用症患者，这很可能是由于过度头低位倾斜时肩支架压迫（以防止头侧滑动）所致。对于该手术，作者建议尽可能限制头低位倾斜的持续时间和程度，避免过多的静脉输液，并尽可能避免使用肩部支架，谨慎定位患者。
Two cases of anaesthetic complications after robotic-assisted laparoscopic radical prostatectomy using the da Vinci Remote-Controlled Surgical System are presented. Case 1 describes a patient with post-extubation respiratory distress requiring re-intubation and subsequent ventilation in an intensive care unit. This was attributed to laryngeal oedema, which was most likely due to the reduction in venous outflow from the head caused by the pneumoperitoneum and prolonged, extreme Trendelenburg position. Case 2 describes a patient with mild brachial plexus neurapraxia, which was most likely due to compression by shoulder braces (to prevent cephalad sliding) during the exaggerated head-down tilt. For this procedure, the authors recommend limiting the duration and extent of head-down tilt as much as possible, avoiding excessive intravenous fluids and careful positioning of the patient with avoidance of shoulder braces whenever possible.