达芬奇机器人肝胆胃肠手术麻醉研究

Anesthesia of patients for hepatobiliary and gastrointestinal surgery with da Vinci S robotics

目的总结达芬奇机器人肝胆胃肠手术251例麻醉临床经验。方法对2008年1月-2011年6月251例达芬奇机器人肝胆胃肠手术麻醉过程及麻醉并发症进行分析总结。结果 251例全程机器人手术麻醉,麻醉时间(456.5±92.4)min,手术时间(414.6±83.6)min,气腹时间(408.7±46.8)min,麻醉手术中血流动力学稳定,气腹时间多于180min者PaCO2比术前基线值明显增加(P<0.05),气腹时间多于360min者动脉血pH比术前基线值明显降低(P<0.05),9例中转开腹未列入本组统计。结论达芬奇机器人腹部手术中患者血流动力学平稳,但气腹时间明显延长,易发生酸碱失衡。

Objective To summarize the clinical anesthesia experiences with 251 cases who underwent hepatobiliary and gastrointestinal surgery with da Vinci S robotics.Methods Anesthesia of 251 patients who underwent hepatobiliary and gastrointestinal surgery with da Vinci S robotics from January 2008 to June 2011 and its complications were analyzed and summarized.Results All patients were anesthetized and underwent surgery with robotics.The anesthesia time was 456.5±92.4min,the operation time was 414.6±83.6min,and the CO2 pneumoperitoneum time was 408.7±46.8min.The hemodynamics of patients was stable during operation.The PaCO2 was significantly higher after 180min of pneumoperitoneum than before operation（P〈0.05）,while the pH was significantly lower after 360min of pneumoperitoneum than before operation（P〈0.05）.Nine cases were transferred for laparotomy.Conclusion The hemodynamics of patients is stable during anesthesia of patients for abdominal operation with da vinci S robotics.The time of CO2 pneumoperitoneum is significantly longer than other surgical procedures,and thus often leading to acid-base disturbance.