达芬奇机器人胸腺瘤切除术的麻醉管理  

Anesthetic Management in Thymectomy with da Vinci STM Surgical System

作　　者：王维[1] 隋波[1] 李冠华[1] 马涛[1] 谢厚云[1] 袁建广[1] 陈秀[2] 韩冰[2] 

机构地区：[1]第二炮兵总医院麻醉科,北京100088 [2]第二炮兵总医院心胸外科,北京100088

出　　处：《中国微创外科杂志》2011年第8期706-708,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的总结达芬奇机器人胸腺瘤切除术的麻醉管理方法。方法在全身麻醉下实施达芬奇机器人胸腺瘤切除术15例,麻醉诱导后插入左侧双腔支气管导管,在达芬奇机器人手术系统使用过程中实施单肺通气,术中监测动脉血气和血流动力学变化。结果 15例均顺利完成手术,无中转开胸,围手术期无死亡病例。单肺通气后12例脉搏氧饱和度(SpO2)一过性下降,未做特殊处理。麻醉时间(130.5±36.6)min,手术时间(121.6±32.9)min,CO2气胸时间(108.4±37.5)min,气胸后30 min患者血压MAP(71.1±11.5)mm Hg,可通过快速输液及给予血管活性药物予以纠正。结论达芬奇机器人胸腺瘤切除术的麻醉管理复杂,CO2气胸及单肺通气对血流动力学及呼吸功能影响较大。Objective To summarize our experience on the anesthesia management of robotic-assisted thymusectomy with da Vinci STM surgical system.Methods Fifteen patients underwent robotic-assisted thymectomy by using da Vinci STM Surgical System.After induction of anesthesia,a left-sided double-lumen endotracheal tube was introduced for single-lung ventilation during operation.Hemodynamics and arterial blood gas were routinely monitored.Results All the patients could tolerate the anesthesia for thymectomy,there was no hospital mortality,nor conversion to open surgery.Twelve patients had transient hypoxaemia after single-lung ventilation.The time of anesthesia was（130.5±36.6） min,operation time was（121.6±32.9） min,and the time for CO2 pneumothorax was（108.4±37.5） min.Thirty minutes after pneumothorax,the patients＇ MAP decreased to（71.1±11.5） mm Hg,which could be corrected by fast infusion or vasopressor.Conclusions The anesthesia management for robotic-assisted thymectomy with da Vinci STM system is complicated.CO2 pneumothorax and single-lung ventilation can lead to instable hemodynamics and respiratory function,which is a big challenge for anesthetists.

关 键 词：麻醉管理 达芬奇手术机器人 胸腺瘤 

分 类 号：R614.2[医药卫生—麻醉学]