国产远程5G机器人泌尿外科手术麻醉管理经验体会  

Anesthesia management experience and literature study of domestic remote 5G robot urology surgery

作　　者：银彩霞[1] 书伦 李轶聪 袁维秀[2] 冯龙[2] Yin Caixia;Shu Lun;Li Yicong;Yuan Weixiu;Feng Long(Department of Anesthesiology,the Third Medical Center of PLA General Hospital,Beijing 100039,China;Department of Anesthesiology,Hainan Hospital,PLA General Hospital,Sanya 472000,China)

机构地区：[1]解放军总医院第三医学中心麻醉科,北京100039 [2]解放军总医院海南医院麻醉科,三亚472000

出　　处：《微创泌尿外科杂志》2024年第5期299-302,共4页Journal of Minimally Invasive Urology

基　　金：海南省自然基金面上项目(824MS171、822MS198、821MS112)。

摘　　要：目的:探讨总结远程5G机器人泌尿外科手术围术期麻醉管理的注意事项及经验总结。方法:2023年8月31日至2023年9月12日于解放军总医院海南医院对3例泌尿外科患者行择期机器人远程手术,术者在北京解放军总医院第三医学中心通过远程5G专线完成手术操作。患者均为男性,年龄分别为23、28、66岁;体质量指数分别为22.2、22.2、27.1 kg/m^(2)。3例患者分别行机器人辅助腹腔镜左肾上腺肿瘤切除术、下腔静脉后输尿管重建术及左肾根治性切除术。结果:所有患者均顺利完成手术,均采用快诱导气管插管全身麻醉,麻醉时间分别为172、116、240 min。2例患者行左侧桡动脉穿刺置管并在术中阶段监测动脉血气,1例行右侧颈内静脉穿刺置管。手术结束后2例患者送麻醉恢复室拔管,1例于手术间拔管。手术时间分别为85、127、155 min,术中出血量分别为10、20、100 ml,尿量分别为100、100、300 ml,输液量分别为1600、1600、2600 ml,所有患者均未输血。住院时间分别为23、13、23 d,术后均未发生任何并发症。结论:远程机器人手术麻醉应选择全身麻醉,术中充分应用肌松药避免体动,加强高级血流动力学监测。同时应加强团队沟通,做好意外风险防范和应急预案。Objective:To explore and summarize the precautions and experience of perioperative anesthesia management in remote 5G robot urology surgery.Methods:From August 31,2023 to September 12,2023,a total of 3 patients with urology underwent elective robotic surgery in Hainan Hospital of PLA General Hospital.The sur-geon completed the surgical operation at the Third Medical Center of the General Hospital of the People's Liberation Army in Beijing through a remote 5G dedicated line.All patients were male,the ages were 23,28,and 66 years,re-spectively;The body mass index were 22.2,22.2,and 27.1 kg/m^(2),respectively.Three patients underwent robot-as-sisted laparoscopic left adrenal tumor resection,retrocaval ureteral reconstruction,and radical left nephrectomy,re-spectively.Results:All patients successfully completed the operations,and all patients were given general anesthesia by fast induction tracheal intubation.The anesthesia time was 172,116,and 240 min,respectively.Two patients un-derwent left radial artery catheterization and arterial blood gas were analyzed during operation,and right internal jugu-lar vein catheterization was performed in 1 case.Two patients were sent to anesthesia recovery room for extubation,and one patient was extubated during operation.The surgical time was 85,127,and 155 min,the intraoperative bleeding volume was 10,20,and 100 ml,the intraoperative urine output was 100,100,and 300 ml,and the infusion volume was 1600,1600,and 2600 ml,respectively.None of the patients received blood transfusion.The hospital stay was 23,13,and 23 days,respectively.No postoperative complication occurred.Conclusion:General anesthesia should be selected for remote 5G robot surgery,muscle relaxation should be sufficient during operation to avoid body movement,and advanced hemodynamic monitoring should be strengthened.In addition,effective preparation for risk prevention and emergency response plans.

关 键 词：远程5G 机器人 泌尿外科 手术 麻醉 

分 类 号：R614.2[医药卫生—麻醉学]