“和平方舟”号医院船首例远海大风浪航行中开腹手术的麻醉处理

Experience from anesthesia on the first case undergoing laporatomy on board a ship in stormy sea

“和平方舟”号医院船是一艘相当于国内三级甲等医院的现代医院船，其医疗设施完备，装备先进。医院船作为最佳的海上救治机构和后送工具，是重要的海上卫勤保障力量，列装后多次执行系列和谐使命任务及人道主义救援任务。在执行“和谐使命-2015”任务中，医院船从澳大利亚至法属波利尼西亚航渡期间，成功实施了航行中开腹胆囊切除术。此例手术是我国首例远海航行中全麻开腹手术，且恰逢大风浪，对患者、手术医生、麻醉医生均是不小的考验，具有较大的借鉴意义。

In an October midnight 2015 a 36-year-old male patient suffering from severe cholecystitis and cholelithiasis underwent emergency operation on board the hospital ship ＂Peace Ark＂ on the stormy sea. The patient was properly fixed on the operating table. The effect of the hull shaking was setoff by intubation with Shikani Optical Styler. Midazolam was used to relieve the anxiety. The doses of propofol and etomidate were reduced since rotational stimulation increases the sensiibity to these drugs. Higher doses of M receptor blockers, such as aptropine and scopolamine were given, due to the increase of the sympathetic nerve tension. Muscle relaxants were appended during laparotomy. Tropisetron helped relieve the nausea syndrome caused by rotational stimulation.