27 KB76 KB29 KB200520132006Novak-Jankovič, VesnaPotočnik, IztokSok, MihaelSrpčič, Matevžletnik:11številka:258 stranistr. 41-48ISSN:1318-8941COBISSID:21156313URN:URN:NBN:SI:doc-44A8LDAAslSlovensko zdravniško društvoEndoskopska revijaanastezijaAnestezijaAnesthesiaastroezofagealni refluksBolečina pooperativnaDrug TherapyGastroesophageal RefluxGastroezofagealni refluksLaparoscopyLaparoskopijalaparoskopska kirurgijaPain, PostoperativePneumoperitoneum, ArtificialPnevmoperitonej umetniPredoperacijsko zdravljenjePremedicationSurgeryAnestezija za laparoskopske operacije pri gastroezofagealni refluksni bolezni - retrospektivna analiza| Anaesthesia for laparoscopic procedures for gastroesophageal reflux disease - a retrospective analysis|Introduction. Laparoscopy began to develop as a diagnostic instrumental examination of the abdominal cavity. It enables surgeons to perform examination and oriented biopsy in a patient friendly manner. The examination has evolved into a minimally invasive surgical technique, which is effectivelyused in an ever-widening range of procedures. The paper presents anaesthesia-related and surgical intra- and postoperative complications, the percentage of conversions from laparoscopy to laparatomy, the length of hospital stay and some specifics of anaesthesia related to pneumoperitoneum. Patients and methods. The authors analysed retrospectively all patients who underwent laparoscopic surgery at the Department of Thoracic Surgery, University Medical Centre Ljubljana from the beginning of 2003 to the end of 2004. The patients received a standard anaesthetic technique: anaesthesia was induced with propofol, fentanyl and vecuronium and was maintained with sevoflurane, fentanyl and vecuronium. After the operation the patients were trasferred to the intensive care unit. Postoperatively, the majority of patients received "patient controlled intravenous analgesia" (PCIA) with piritramide. In the remainder pain relief was provided by diclofenac with orphenadrine by intra-venous infusion or morphine, bupivacaine and clonidine by "patient controlled epidural analgesia" (PCEA). The data were analysed using SPSS for Windows or MS Excel. Results. Laparoscopic approach was used in48 patients, mainly for gastro-oesophageal reflux disease. An equal number of females and males were operated on. The patients were of normal build; mostof them were in American Society of Anesthesiology (ASA) II class. The coversion rate was 2.1% and the average time of hospital stay 5.5 days. The only intraoperative surgical complications were bleeding and oesophageal perforation. (Abstract truncated at 2000 characters)Izhodišča. Laparoskopija se je sprva začela razvijati kot diagnostična instrumentalna preiskava trebušne votline. Omogočala je predvsem pregled in usmerjene biopsije na bolniku prijazen način. Kasneje je prerastla v minimalnoinvazivno kirurško tehniko, ki omogoča vedno širšo paleto kirurških posegov. V prispevku prikazujemo anesteziološke in kirurške medoperativne in pooperativne zaplete pri naših bolnikih, stopnjo preklopov laparoskopskih posegov v klasične, trajanje hospitalizacije bolnikov ter posebnosti anestezije zaradi pnevmoperitoneja pri laparoskopsko operiranih bolnikih. Bolniki in metode. Retrospektivno smo obdelali podatke bolnikov, operiranih z laparoskopsko tehniko na KO za torakalno kirurgijo KC Ljubljana v dveletnem obdobju (od začetka leta 2003, do konca leta 2004). Bolniki so bili anestezirani s standardno anestezijsko tehniko, ki se uporablja za tovrstne posege. Za indukcijo smo uporabili kombinacijo propofola, fentanila in vekuronija. Anestezijo smo vzdrževali s kombinacijo sevoflurana, fentanila in vekuronija. Po operaciji so bili bolniki premeščeni v Enoto intenzivne nege. Večini bolnikov smo blažili pooperacijsko bolečino s piritramidom vensko s črpalko PCIA (patient controlled intravenous analgesia), manjši delež bolnikov je prejel pooperacijsko infuzijo diklofenaka z orfenadrinom ali pa epiduralni kateter s črpalko PCEA (patient controlled epidural analgesia). Podatke smo obdelali s pomočjo programa SPSS for Windows in MS Excel. Rezultati. Laparoskopsko je bilo v obdobju od začetka leta 2003 do konca leta 2004 na KO za torakalno kirurgijo KC Ljubljana operiranih 48 bolnikov, največkrat zaradi gastroezofagealne refluksne bolezni (GERB), ko je bila opravljena antirefluksna operacija. Operiranih je bilo enako število moških in žensk. Bolniki so bili povprečne somatske konstitucije. Največ bolnikov je bilo umeščenih v razred ASA 2. (Izvleček prekinjen pri 2000 znakih)TEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaSlovensko zdravniško društvo, Združenje za endoskopsko kirurgijo