Jaypee Brothers
In Current Chapter
In All Chapters
X
Clear
X
GO
Normal
Sepia
Dark
Default Style
Font Style 1
Font Style 2
Font Style 3
Less
Normal
More
Anaesthesia in Laparoscopic Surgery
Jayashree Sood, Anil Kumar Jain
CHAPTER 1:
History of Laparoscopic Procedures
INTRODUCTION
CONCLUSION
CHAPTER 2:
Gases Used in Laparoscopic Surgery
INTRODUCTION
AIR
OXYGEN
NITROGEN
NITROUS OXIDE (FIG. 2.2)
CARBON DIOXIDE
COMPLICATIONS DUE TO INSUFFLATION OF CO2
PROMOTION OF PORT-SITE TUMOUR GROWTH
HELIUM
ARGON
CONCLUSIONS
CHAPTER 3:
Ideal IAP during Laparoscopy
INTRODUCTION
WHAT IS THE INTRA-ABDOMINAL PRESSURE?
PHYSIOLOGICAL EFFECTS AT LOW IAP (7-10 mmHG)
PHYSIOLOGICAL EFFECTS AT STANDARD IAP (12-15 mmHG)
PHYSIOLOGICAL EFFECTS AT HIGH IAP (>15mmHG)
DISADVANTAGES OF HIGH IAP
ADVANTAGES OF LOW IAP
CONCLUSIONS
CLINICAL PEARLS
CHAPTER 4:
Haemodynamic Effects of Pneumoperitoneum
INTRODUCTION
CARDIOVASCULAR EFFECTS
CHANGES IN CARDIOVASCULAR FUNCTION
PHASIC NATURE
PATIENT POSITION
CAUSES OF HAEMODYNAMIC CHANGES (FIG. 4.1)
SGRH EXPERIENCE
PATIENTS WITH CARDIAC DISEASE
CHAPTER 5:
Effect of Pneumoperitoneum on Respiratory System
INTRODUCTION
RESPIRATORY CHANGES DURING LAPAROSCOPY
VENTILATORY CHANGES
INCREASE IN PaCO2
PHYSIOLOGICAL EFFECTS OF CARBON DIOXIDE
PATIENT POSITION
INFLUENCE OF ANAESTHESIA
MONITORING OF PaCO2 AND EtCO2
SUMMARY
CLINICAL PEARLS
CHAPTER 6:
Effect of Carboperitoneum on CNS Physiology
INTRODUCTION
CONCLUSIONS
CLINICAL PEARLS
CHAPTER 7:
Effect of Carboperitoneum on Renal Physiology
REVIEW OF NORMAL RENAL PHYSIOLOGY
EFFECTS OF ELEVATED INTRA-ABDOMINAL PRESSURE (IAP) ON RENAL PHYSIOLOGY
CONCLUSION
CLINICAL PEARLS
CHAPTER 8:
Stress Response and Laparoscopy
INTRODUCTION
NORMAL STRESS RESPONSE1
HORMONAL RESPONSE TO SURGERY1
ACTIVATION OF STRESS RESPONSE FACTORS
Cytokines1,2
TNF-α1,2
Interleukin-61,2
C-Reactive Protein1,2
FEATURES OF ACUTE PHASE RESPONSE
STRESS RESPONSE IN LAPAROSCOPIC SURGERY
ENDOSCOPIC SURGERY AND ENDOCRINE METABOLIC RESPONSE
ENDOSCOPIC SURGERY AND INFLAMMATORY RESPONSE AND IMMUNE FUNCTION
EFFECT OF ENDOSCOPIC SURGERY ON PULMONARY FUNCTION AND HYPOXAEMIA
POSTOPERATIVE GASTROINTESTINAL PARALYSIS AND OTHER PHYSIOLOGICAL RESPONSES TO SURGERY
SPLANCHNIC TISSUE OXYGENATION
CLINICAL IMPLICATIONS
CONCLUSION
CLINICAL PEARLS
CHAPTER 9:
General Anaesthesia for Laparoscopic Surgery
INTRODUCTION
PATHOPHYSIOLOGY OF PNEUMOPERITONEUM
RESPIRATORY SYSTEM
INCREASE IN PaCO2
POSTOPERATIVE CHANGES
HAEMODYNAMIC CHANGES
INTRA-ABDOMINAL ORGANS
EFFECT ON PERIPHERAL VASCULAR SYSTEM
INTRA CRANIAL PRESSURE CHANGES
PATIENT POSITION
ANAESTHESIA FOR LAPAROSCOPY
PREOPERATIVE EVALUATION OF THE PATIENT AND PREMEDICATION
ANAESTHETIC TECHNIQUES
GENERAL ANAESTHESIA
VOLATILE ANAESTHETICS (FIG. 9.4)
CONSIDERATION IN CHOOSING INTRA-VENOUS ANAESTHETIC AGENTS
PROPOFOL
BARBITURATES
Benzodiazepines
ETOMIDATE
TOTAL INTRAVENOUS ANAESTHESIA (TIVA) (FIG. 9.5)
MUSCLE RELAXANTS
LOCAL AND REGIONAL ANAESTHESIA
MONITORING (FIG. 9.6)
POSTOPERATIVE CARE AND PAIN RELIEF
POSTOPERATIVE BENEFITS OF LAPAROSCOPY
CARBOPERITONEUM RELATED COMPLICATIONS
CARBON DIOXIDE GAS EMBOLISM
PULMONARY ASPIRATION
PNEUMOTHORAX, SUBCUTANEOUS EMPHYSEMA AND PNEUMOMEDIASTINUM
THROMBOEMBOLISM
CARDIOVASCULAR
POSTOPERATIVE NAUSEA AND VOMITING (PONV)
CHAPTER 10:
Regional Anaesthesia in Laparoscopic Surgery
INTRODUCTION
PHYSIOLOGY DURING LAPAROSCOPY
RESPIRATORY SYSTEM
CARDIOVASCULAR SYSTEM
DISADVANTAGES OF REGIONAL ANAESTHESIA
ANAESTHETIC MANAGEMENT
PREMEDICATION
LAPAROSCOPIC CHOLECYSTECTOMY
GYNAECOLOGICAL LAPAROSCOPIC PROCEDURES
LAPAROSCOPIC HERNIORRHAPHY
LAPAROSCOPIC GASTROINTESTINAL SURGERIES
LOCAL ANAESTHESIA
CONCLUSIONS
CLINICAL PEARLS
CHAPTER 11:
Use of LMA and Surgery PLMA in Laparoscopic and Extraperitoneal Endoscopic Surgery
INTRODUCTION
PHYSIOLOGIC CHANGES DURING LAPAROSCOPIC AND EXTRAPERITONEAL ENDOSCOPIC SURGERY
PULMONARY MECHANICS IN LAPAROSCOPIC SURGERY
AIRWAY MANAGEMENT FOR LAPAROSCOPIC SURGERY (FIG. 11.1)
LMA-FAMILY (FIG. 11.2)
CLASSIC LMA, FLEXIBLE LMA, LMA UNIQUE (FIG. 11.3)
THE INTUBATING LMA AND LMA CTRACH
THE PROSEAL LMA (PLMA) (FIGS 11.4 TO 11.6)
ROLE OF LMA AND PLMA IN LAPAROSCOPIC SURGERY
SOLE AIRWAY DEVICE39–46,26–33
Gynaecologic Laparoscopy
Laparoscopic Cholecystectomy
Other Procedures
DIFFICULT AIRWAY
FAILED INTUBATION
COEXISTING DISEASE
DESIRABLE MONITORING DURING LAPAROSCOPIC SURGERY WITH LMA AS AN AIRWAY
COMPLICATIONS
CONCLUSION
CLINICAL PEARLS
CHAPTER 12:
Anaesthesia for Laparoscopic Cholecystectomy
INTRODUCTION
PHYSIOLOGIC CHANGES
POSITION OF PATIENT
Trendelenburg Position
Reverse Trendelenburg Position
CREATION OF CARBOPERITONEUM (FIG. 12.2)
INTRA-ABDOMINAL PRESSURE (IAP)
PRE-ANAESTHETIC ASSESSMENT
PREMEDICATION
MONITORING (FIG. 12.3)
ANAESTHETIC TECHNIQUE
GENERAL ANAESTHESIA (FIG. 12.4)
Perioperative Narcotics
REGIONAL ANAESTHESIA (FIG. 12.6)
LOCAL ANAESTHESIA
POSTOPERATIVE MORBIDITY
POSTOPERATIVE PAIN
POSTOPERATIVE NAUSEA AND VOMITING (PONV)
COMPLICATIONS OF LAPAROSCOPIC CHOLECYSTECTOMY
TROCAR INSERTION
CARBOPERITONEUM AND INCREASED IAP
EXOGENOUS CO2
VENOUS CO2 EMBOLISM
CONCLUSIONS
CLINICAL PEARLS
CHAPTER 13:
Laparoscopic Repair of Abdominal Hernias: Anaesthetic Considerations
INTRODUCTION
THE LEARNING CURVE
PATHOPHYSIOLOGICAL CHANGES DURING ENDOSCOPIC HERNIA REPAIR
POSITION OF THE PATIENT
INSUFFLATION OF EXOGENOUS GAS
CARBOPERITONEUM AND INCREASED INTRA-ABDOMINAL PRESSURE
REPERCUSSIONS OF PNEUMOPERITONEUM IN SPECIAL PATIENT GROUPS
PATIENT WITH CARDIAC DISEASE (TABLE 13.2)
PULMONARY DISEASE (TABLE 13.3)
PAEDIATRIC PATIENTS
CHOICE OF ANAESTHETIC TECHNIQUE
PREMEDICATION
MONITORING (TABLE 13.4)
GENERAL ANAESTHESIA
REGIONAL ANAESTHESIA
SPINAL ANAESTHESIA
EPIDURAL ANAESTHESIA
COMBINED SPINAL AND EPIDURAL ANAESTHESIA
LOCAL ANAESTHESIA
COMPLICATIONS
SUBCUTANEOUS EMPHYSEMA
PNEUMOTHORAX
CONCLUSIONS
CLINICAL PEARLS
CHAPTER 14:
Anaesthesia for Ambulatory Laparoscopic Surgery
INTRODUCTION
PREOPERATIVE EVALUATION
HIGH-RISK GROUP FOR DAY CARE LAPAROSCOPY
Respiratory Diseases
Ischaemic Heart Disease
Obesity
PREMEDICATION
PNEUMOPERITONEUM
PATIENT POSITIONING
ANAESTHETIC TECHNIQUE
INTRAVENOUS TECHNIQUES IN AMBULATORY ANAESTHESIA
TARGET-CONTROLLED INFUSION (TCI)
LIMITS OF INTRAVENOUS TECHNIQUES IN AMBULATORY PATIENTS
AIRWAY CONTROL FOR LAPAROSCOPY IN DAYCARE
LARYNGEAL MASK AIRWAY (LMA) FOR LAPAROSCOPY
MUSCLE RELAXANTS
REGIONAL ANAESTHESIA FOR LAPAROSCOPY
SPINAL ANAESTHESIA
EPIDURAL ANAESTHESIA
COMBINED SPINAL-EPIDURAL ANAESTHESIA (CSEA)
LOCAL ANAESTHETIC INFILTRATION
Patient Safety and Satisfaction
MONITORING
RECOVERY AFTER LAPAROSCOPY
POSTOPERATIVE NAUSEA AND VOMITING
POSTOPERATIVE PAIN
CONCLUSIONS
CLINICAL PEARLS
CHAPTER 15:
Anaesthesia for Gynaecologic Laparoscopy
INTRODUCTION
HISTORY1
PROCEDURES
MANAGEMENT OF ANAESTHESIA
PATIENT PREPARATION
MONITORING
ANAESTHESIA TECHNIQUE
Anaesthetic Induction
Muscle Relaxation
Inhalational Agents
Alternative Airway
Analgesia
Special Situations
POSTOPERATIVE RECOVERY AND ANALGESIA
CRITICAL ISSUES
PROCEDURE RELATED
Use of Nitrous Oxide
Position
Gastric Tube Insertion
Urine Output Monitoring
ANAESTHESIA RELATED
Regional and Local Anaesthesia for Laparoscopy
Airway
COMPLICATIONS OF GYNECOLOGIC LAPAROSCOPY
CURRENT RESEARCH
CONCUSSIONS
CLINICAL PEARLS
CHAPTER 16:
Laparoscopic Surgery in Pregnancy
INTRODUCTION
PHYSIOLOGICAL CHANGES (TABLE 16.1)
EFFECT OF CARBOPERITONEUM ON THE RESPIRATORY SYSTEM
CARDIOVASCULAR SYSTEM7
RENAL SYSTEM3,4,5,7
COAGULATION
GASTROINTESTINAL SYSTEM2,3,4,11
UTEROPLACENTAL BLOOD FLOW
EFFECT OF CARBOPERITONEUM ON THE FETUS
OTHER ISSUES
IMMUNOLOGICAL STATUS
ALTERNATIVES TO CARBOPERITONEUM
USE OF ELECTROCAUTERY IN A PREGNANT PATIENT
REMOVAL OF SPECIMEN IN LAPAROSCOPY
WHICH TRIMESTER IS SAFE FOR SURGERY (Table 16.3)
TIME AND EXPOSURE
ANESTHETIC DRUGS
POSITIONING
MONITORING OF A PREGNANT PATIENT UNDERGOING LAPAROSCOPY
FOETAL MONITORING
CONCLUSIONS
CHAPTER 17:
Anaesthesia for Laparoscopy in Paediatric Patients
INTRODUCTION
PATHOPHYSIOLOGY OF CARBOPERITONEUM IN A CHILD
INTRA-ABDOMINAL PRESSURE AND LAPAROSCOPY
EFFECTS ON HAEMODYNAMICS
EFFECTS ON RESPIRATORY SYSTEM
EFFECTS ON INTRACRANIAL PRESSURE
STRESS RESPONSE
ANAESTHETIC MANAGEMENT
STATUS OF LMA IN LAPAROSCOPY
MANAGEMENT OF POSTOPERATIVE PAIN
MANAGEMENT OF PONV
GASLESS LAPAROSCOPY
CONCLUSIONS
CLINICAL PEARLS
CHAPTER 18:
Anaesthetic Considerations Surgery Considerations in Urologic Laparoscopic Surgery
INTRODUCTION
LAPAROSCOPIC APPROACHES IN UROLOGY SURGERY
PATIENT POSITIONING DURING UROLOGICAL LAPAROSCOPY
PHYSIOLOGICAL CHANGES PERTAINING TO POSITIONING OF PATIENT
THE LATERAL DECUBITUS (THE KIDNEY POSITION) POSITION
THE TRENDELENBURG POSITION
HYPERLORDOTIC POSITION
PHYSIOLOGICAL EFFECTS PERTAINING TO CO2 INSUFFLATION
CARDIOVASCULAR EFFECTS
RESPIRATORY EFFECTS
RENAL EFFECTS
CEREBROVASCULAR EFFECTS
TEMPERATURE CHANGES
VENOUS THROMBOEMBOLISM
METHODS OF PROPHYLAXIS
PREVENTIVE STRATEGIES
SELECTION OF PATIENT
SPECIFIC APPLICATIONS
LAPAROSCOPIC ADRENALECOMY
LAPAROSCOPIC SURGERY FOR PHEOCHROMOCYTOMA
LAPAROSCOPIC DONOR NEPHRECTOMY
LAPAROSCOPIC RADICAL PROSTATECTOMY
URINARY INCONTINENCE
ANAESTHESIA
MONITORING
CLINICAL PEARLS
CHAPTER 19:
Complications in Laparoscopic Surgery
INTRODUCTION
INCIDENCE
CLASSIFICATION
ANAESTHESIA RELATED
Due to Introduction of Pneumoperitoneum
Trocar Injuries
Thermal Injuries26,27
POSTOPERATIVE COMPLICATIONS
CONCLUSIONS
CLINICAL PEARLS
CHAPTER 20:
Anaesthetic Management for Laparoscopic Bariatric Surgery
INTRODUCTION
WHO IS TERMED “OBESE”?
ELIGIBILITY OR INDICATIONS FOR BARIATRIC PROCEDURES?
BARIATRIC SURGERY PROCEDURES2
PHYSIOLOGICAL CHANGES
EFFECTS OF CARBON DIOXIDE ABSORPTION DURING CARBOPERITONEUM
EFFECT OF INCREASED IAP DURING CARBOPERITONEUM
PATHOPHYSIOLOGY OF THE RESPIRATORY SYSTEM10
EFFECT OF CARBOPERITONEUM ON THE RESPIRATORY SYSTEM (TABLES 20.1 AND 20.2)
HAEMODYNAMIC CHANGES AND CARDIOVASCULAR CHANGES12
EFFECT OF CARBOPERITONEUM ON THE CARDIOVASCULAR SYSTEM (TABLE 20.3)
HEPATIC FUNCTION DURING LAPAROSCOPY (TABLE 20.4)
CARBOPERITONEUM AND RENAL CHANGES (TABLE 20.5)
CARBOPERITONEUM AND VENOUS STASIS (TABLE 20.6)
PREOPERATIVE EVALUATION
CARDIOVASCULAR SYSTEM21-23
RESPIRATORY SYSTEM
GASTROINTESTINAL SYSTEM
ENDOCRINE SYSTEMS
ANTIOBESITY AND OTHER CONCURRENT MEDICATIONS
AIRWAY ASSESSMENT
REPEAT BARIATRIC SURGERY
PREOPERATIVE INVESTIGATIONS
PREMEDICATION
INDUCTION OF ANAESTHESIA
PREOXYGENATION
CHOICE OF INDUCTION AGENTS27
MUSCLE RELAXATION
AIRWAY POSITION
POSITIONING
MONITORING (FIG. 20.6)
INTRAOPERATIVE PROBLEMS
BLOOD PRESSURE MEASUREMENT
MAINTENANCE OF ANAESTHESIA
FLUID REPLACEMENT
VENTILATION (FIG. 20.7)
TRACHEAL EXTUBATION
MONTEFIORE OBESITY SURGERY SCORE32
SHIFTING OF THE PATIENT
POSTOPERATIVE CONSIDERATIONS
RESPIRATORY PROBLEMS
AMBULATION32
ANALGESIC REGIMES
CONCLUSIONS
CHAPTER 21:
Laparoscopy in High-Risk Cardiac Cases
INTRODUCTION
INSUFFLATION OF CARBON DIOXIDE
HYPERCARBIA
PATIENT POSITIONING
INCREASED INTRA-ABDOMINAL PRESSURE
CONCLUSIONS
RECOMMENDATIONS (AS IN TABLE 21.1)
CHAPTER 22:
Pain Management after Laparoscopic Procedures
INTRODUCTION
SHOULDER PAIN
PRE-EMPTIVE ANALGESIA
PREVENTIVE ANALGESIA
LOCAL ANAESTHETIC
LOCAL ANAESTHESIA INCISIONAL INFILTRATION
INTRAPERITONEAL LOCAL ANAESTHETIC
PHARMACOLOGICAL MODALITIES
ACETAMINOPHEN
NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDs)
OPIOIDS
MULTIMODAL ANALGESIC TECHNIQUE
ADVANCEMENT IN SURGICAL TECHNIQUES
CONCLUSIONS
CLINICAL PEARLS
CHAPTER 23:
Anaesthesia for Thoracoscopy
INTRODUCTION
INDICATIONS OF THORACOSCOPY2,3
CONTRAINDICATIONS OF THORACOSCOPY3
ABSOLUTE
RELATIVE
ANAESTHESIA TECHNIQUES FOR THORACOSCOPY
LOCAL ANAESTHESIA
REGIONAL ANAESTHESIA
Mechanism of Mediastinal Shift and Paradoxical Respiration5
GENERAL ANAESTHESIA
Spontaneous Ventilation
Use of LMA or facemask for airway management in spontaneous ventilation
Controlled Ventilation with Single Lumen Tracheal Tube3,11
CO2 insufflation (Capnothorax)
Controlled Ventilation with Double Lumen Tracheal Tube
ANAESTHETIC MANAGEMENT FOR THORACOSCOPY
PREOPERATIVE EVALUATION
PHYSICAL EXAMINATION
INVESTIGATIONS
PREOPERATIVE PREPARATION
MONITORING
COMPLICATIONS
Pulmonary
Cardiac
Technical
Other Complications
POSTOPERATIVE PAIN MANAGEMENT
POSTOPERATIVE MANAGEMENT
THORACOSCOPY IN PEDIATRIC PATIENTS19
PREOPERATIVE EVALUATION
PREMEDICATION AND TECHNIQUES OF ANAESTHESIA
PERIOPERATIVE ANAESTHETIC CARE
Local and Regional Anaesthetic Techniques
CONCLUSIONS
RECOMMENDATIONS FOR THORACOSCOPY
INDEX
TOC
Index
×
Chapter Notes
Save
Clear