anesthsia in laparoscopy
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This document discusses various medical topics including: 1. Research showing that using a laryngeal mask airway (LMA) during surgery results in lower heart rate, blood pressure, and respiratory rate than using an endotracheal tube, helping reduce surgical stress. 2. Information on laparoscopic surgery techniques and how they can help reduce surgical stress and recovery time compared to conventional open surgeries. 3. Details on carbon dioxide absorption during surgery and some of its effects on the body like mild acidosis and potential to cause hypothermia in large amounts.
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Seminar on laparoscopic surgery and its anaesthetic consideration
Laparoscopic surgery offers advantages like less tissue trauma, decreased postoperative pain, and shorter hospital stays compared to open surgery. However, pneumoperitoneum (insufflation of carbon dioxide gas) and patient positioning during laparoscopy can impact respiratory, cardiovascular, and renal systems. Anesthesiologists aim to maintain hemodynamic stability, respiratory stability, adequate muscle relaxation, analgesia, and prevent hypothermia and deep vein thrombosis during laparoscopic procedures.
Anesthesia for laparoscopic surgeries
This document provides an overview of anesthesia for laparoscopic surgery. It begins with a brief history of laparoscopy and then discusses the advantages and disadvantages, common procedures, equipment used, physiological changes caused by pneumoperitoneum, and anesthesia considerations and management. Key points include the respiratory, cardiovascular and renal effects of increased intra-abdominal pressure from carbon dioxide insufflation. Close monitoring is needed to prevent complications like gas embolism, pneumothorax, and arrhythmias that can potentially occur during laparoscopic procedures.
Anaesthesia for laparoscopic surgery_Dr. Tanmoy Roy
Laparoscopy, also known as peritoneoscopy, is a minimally invasive surgical procedure that uses carbon dioxide gas to create space in the abdominal cavity for endoscopic access. While it provides smaller incisions and faster recovery compared to open surgery, laparoscopy can cause various physiological changes in patients due to pneumoperitoneum and positioning. Close monitoring of ventilation, oxygenation, and hemodynamics is important to prevent potential complications such as hypercapnia, gas embolism, and cardiac dysrhythmias. General anesthesia with controlled mechanical ventilation is preferred to provide an immobile surgical field and protect the airway, while regional anesthesia requires lower insufflation pressures which limit visualization.
Seminar on laparoscopic surgery and its anaesthetic consideration1
Laparoscopic surgery presents several anesthetic challenges due to pneumoperitoneum and patient positioning. Pneumoperitoneum can cause respiratory, cardiovascular, gastrointestinal, and other physiological changes. Careful monitoring and management is needed to address issues like hypercarbia, hemodynamic instability, hypothermia, and rare but serious complications like gas embolism. While offering benefits over open surgery, laparoscopy requires an anesthetic approach tailored to each patient's health and the specific procedures being performed.
Anaesthesia for laproscopic procedures (18 jan)
Laparoscopy involves visualizing the abdominal cavity through an endoscope inserted through small incisions. Carbon dioxide is used to insufflate the abdomen and provide working space. Anesthesia aims to minimize physiological effects of pneumoperitoneum on the cardiovascular, respiratory, and central nervous systems through fluid loading, controlled ventilation with PEEP, and limiting increases in intra-abdominal pressure. Complications include subcutaneous emphysema, gas embolism, and respiratory issues related to diaphragm movement. Postoperative management focuses on analgesia and preventing postoperative nausea and vomiting.
Anaesthesia For Laparoscopy
1) Laparoscopic surgery involves risks from insufflation of carbon dioxide into the peritoneum, which can cause cardiovascular and respiratory effects.
2) The anesthesiologist must carefully monitor the patient and choose an appropriate anesthetic technique to accommodate the physiological changes during laparoscopy and allow for early detection of potential complications.
3) While laparoscopy may offer advantages over open surgery, more research is still needed to determine whether the stress response and postoperative recovery is truly less than open procedures, especially for longer surgeries.
Anesthesia in Laparoscopic Surgery
Surgical procedures have been improved to reduce trauma to the pt, morbidity, mortality and hospital stay with consequent reduction in health care cost.
Many painful operations that once required prolonged hospitalizations are now being performed on an out Pt or short stay basis.
the implications for anesthesiologist are to use the technique that not only allows for optimal surgical conditions, but intraoperative Pt comfort and safety, and a rapid anesthetic recovery
The development of better equipment and facilities, along with increased knowledge and understanding of anatomy and pathology have allowed the development of endoscopy for diagnostic and operative procedure. Starting from 1970 used various pathologic gynecological conditions have been diagnosed and treated with laparoscope.
Prof. Mridul Panditrao's Peri-operative MANAGEMENT OF Patients for Laparoscopy
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Laparoscopic surgery offers advantages like less tissue trauma, decreased postoperative pain, and shorter hospital stays compared to open surgery. However, pneumoperitoneum (insufflation of carbon dioxide gas) and patient positioning during laparoscopy can impact respiratory, cardiovascular, and renal systems. Anesthesiologists aim to maintain hemodynamic stability, respiratory stability, adequate muscle relaxation, analgesia, and prevent hypothermia and deep vein thrombosis during laparoscopic procedures.
Anesthesia for laparoscopic surgeries
This document provides an overview of anesthesia for laparoscopic surgery. It begins with a brief history of laparoscopy and then discusses the advantages and disadvantages, common procedures, equipment used, physiological changes caused by pneumoperitoneum, and anesthesia considerations and management. Key points include the respiratory, cardiovascular and renal effects of increased intra-abdominal pressure from carbon dioxide insufflation. Close monitoring is needed to prevent complications like gas embolism, pneumothorax, and arrhythmias that can potentially occur during laparoscopic procedures.
Anaesthesia for laparoscopic surgery_Dr. Tanmoy Roy
Laparoscopy, also known as peritoneoscopy, is a minimally invasive surgical procedure that uses carbon dioxide gas to create space in the abdominal cavity for endoscopic access. While it provides smaller incisions and faster recovery compared to open surgery, laparoscopy can cause various physiological changes in patients due to pneumoperitoneum and positioning. Close monitoring of ventilation, oxygenation, and hemodynamics is important to prevent potential complications such as hypercapnia, gas embolism, and cardiac dysrhythmias. General anesthesia with controlled mechanical ventilation is preferred to provide an immobile surgical field and protect the airway, while regional anesthesia requires lower insufflation pressures which limit visualization.
Seminar on laparoscopic surgery and its anaesthetic consideration1
Laparoscopic surgery presents several anesthetic challenges due to pneumoperitoneum and patient positioning. Pneumoperitoneum can cause respiratory, cardiovascular, gastrointestinal, and other physiological changes. Careful monitoring and management is needed to address issues like hypercarbia, hemodynamic instability, hypothermia, and rare but serious complications like gas embolism. While offering benefits over open surgery, laparoscopy requires an anesthetic approach tailored to each patient's health and the specific procedures being performed.
Anaesthesia for laproscopic procedures (18 jan)
Laparoscopy involves visualizing the abdominal cavity through an endoscope inserted through small incisions. Carbon dioxide is used to insufflate the abdomen and provide working space. Anesthesia aims to minimize physiological effects of pneumoperitoneum on the cardiovascular, respiratory, and central nervous systems through fluid loading, controlled ventilation with PEEP, and limiting increases in intra-abdominal pressure. Complications include subcutaneous emphysema, gas embolism, and respiratory issues related to diaphragm movement. Postoperative management focuses on analgesia and preventing postoperative nausea and vomiting.
Anaesthesia For Laparoscopy
1) Laparoscopic surgery involves risks from insufflation of carbon dioxide into the peritoneum, which can cause cardiovascular and respiratory effects.
2) The anesthesiologist must carefully monitor the patient and choose an appropriate anesthetic technique to accommodate the physiological changes during laparoscopy and allow for early detection of potential complications.
3) While laparoscopy may offer advantages over open surgery, more research is still needed to determine whether the stress response and postoperative recovery is truly less than open procedures, especially for longer surgeries.
Anesthesia in Laparoscopic Surgery
Surgical procedures have been improved to reduce trauma to the pt, morbidity, mortality and hospital stay with consequent reduction in health care cost.
Many painful operations that once required prolonged hospitalizations are now being performed on an out Pt or short stay basis.
the implications for anesthesiologist are to use the technique that not only allows for optimal surgical conditions, but intraoperative Pt comfort and safety, and a rapid anesthetic recovery
The development of better equipment and facilities, along with increased knowledge and understanding of anatomy and pathology have allowed the development of endoscopy for diagnostic and operative procedure. Starting from 1970 used various pathologic gynecological conditions have been diagnosed and treated with laparoscope.
Prof. Mridul Panditrao's Peri-operative MANAGEMENT OF Patients for Laparoscopy
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Laparoscopic surgery has several benefits over open surgery such as reduced postoperative pain, quicker recovery times, and fewer wound complications. However, the pneumoperitoneum required for laparoscopy can cause physiological changes that require careful management to avoid risks. Specific patient factors, surgical risks, positioning risks, and effects of the elevated abdominal pressure from the pneumoperitoneum like decreased cardiac output and impaired lung function must be addressed with appropriate anesthesia techniques and postoperative monitoring. Close attention is needed for patients at higher risk of complications during and after laparoscopic procedures.
Laparoscopic surgery & it's anaesthetic management
This document provides information on laparoscopic surgery:
- It was first introduced in the 20th century and has since been used for various gynaecological and general surgical procedures.
- The main physiological concerns during laparoscopy are related to insufflation of carbon dioxide including increased intra-abdominal pressure and hypercarbia.
- Laparoscopy has advantages like less pain, shorter recovery time and hospital stay compared to open surgeries.
- Expertise is required due to challenges like impaired touch sensation and inability to have a 3D view.
Ppp pneumoperitoneum
This document discusses techniques for creating pneumoperitoneum during laparoscopic surgery. It describes the closed veress needle technique and open techniques for accessing the abdominal cavity. It covers confirmation of needle placement, alternate puncture sites, and the Hasson and umbilical cicatrix tube methods for open access. Physiological effects of pneumoperitoneum and positioning are summarized, including effects on respiratory, cardiovascular, and renal systems. Potential complications from pneumoperitoneum like injuries, respiratory issues, gas embolism, and cardiovascular effects are outlined. Gases used for insufflation like carbon dioxide, nitrous oxide, helium, and argon are compared.
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This document discusses anaesthesia considerations for laparoscopic surgery. It begins by introducing laparoscopy as a minimally invasive surgical procedure using small incisions and insufflated gas to create space in the abdominal cavity. It then outlines the advantages of laparoscopy like reduced trauma, morbidity, and hospital stay compared to open surgery. The document discusses various anaesthetic techniques for laparoscopy including general anaesthesia, regional anaesthesia and their pros and cons. It also covers hemodynamic, respiratory, and other physiological changes associated with pneumoperitoneum and patient positioning during laparoscopy. Complications related to laparoscopy and their management are also summarized.
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- Laparoscopy has advantages over open surgery like shorter hospital stays and faster recovery, but can pose respiratory and cardiovascular risks under anesthesia.
- Maintaining adequate ventilation and oxygenation can be challenging due to absorption of carbon dioxide and positioning effects.
- Gas embolism is a serious risk if gas is directly injected into blood vessels, which can cause hypotension, arrhythmias and death if massive.
- Patient positioning like head-down can increase risks like elevated intracranial pressure and decreased cardiac output that anesthesiologists must manage closely.
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This document discusses laparoscopic surgery and anesthesia considerations. It covers the history and benefits of laparoscopic surgery, as well as risks such as CO2 pneumoperitoneum and positioning effects. It provides guidance on insufflator gas selection and management of cardiovascular, respiratory, gastrointestinal and other physiological impacts. Common procedures are listed. Risk factors, complications and their management are outlined.
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This document discusses the anesthetic management considerations for laparoscopic surgery. Some key points include: carbon dioxide is used to create pneumoperitoneum during laparoscopy due to its solubility in blood; positioning and carbon dioxide absorption can affect hemodynamics and respiration; careful fluid management and monitoring are important due to physiologic effects; and complications may include subcutaneous emphysema, capnothorax, or cardiovascular issues if not properly managed. A multimodal approach is recommended to minimize complications and optimize outcomes.
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Laparoscopy involves inserting surgical instruments through small incisions in the abdomen while insufflating carbon dioxide gas to elevate the abdominal wall for better visualization. This document discusses the physiological changes that occur during laparoscopy, including cardiovascular, respiratory, renal, and metabolic effects. Cardiovascular changes are initially due to increased venous return but later decreased blood flow from elevated pressures. Respiratory changes involve decreased lung capacity but CO2 is typically eliminated through increased breathing. Renal effects include reduced filtration but are usually mild and reversible.
anaesthesia for lap cholecystectomy
A 41-year-old female presented with right upper quadrant abdominal pain and was diagnosed with symptomatic gallstones and acute cholecystitis. She underwent a laparoscopic cholecystectomy under general anesthesia. General anesthesia was induced and tracheal intubation was performed. Pneumoperitoneum was created and maintained at 12 mmHg during the laparoscopic procedure. The surgery was completed without complications and the patient was extubated and transferred to the recovery unit in a stable condition.
Anaesthesia for laparoscopic surgeries
This document provides an overview of anesthesia considerations for laparoscopic surgeries. It discusses the history of laparoscopy, physiological effects of pneumoperitoneum including on the cardiovascular, respiratory, central nervous and renal systems. It also outlines respiratory complications like subcutaneous emphysema, pneumothorax, gas embolism and their treatment. The effects of patient positioning and conduct of anesthesia are summarized.
Anaesthesia for laparoscopy
This document provides an overview of anaesthesia considerations for laparoscopy. It discusses how carbon dioxide is used to insufflate the peritoneal cavity and create pneumoperitoneum during laparoscopy. This causes various physiological changes including increased systemic vascular resistance, decreased cardiac output, respiratory effects like elevated diaphragm and hypercarbia. It outlines management of hemodynamic and respiratory complications during laparoscopy. Complications discussed include subcutaneous emphysema, pneumothorax, gas embolism. The document provides details on anaesthetic concerns for patient positioning, estimated blood loss and managing cardiovascular instability during laparoscopy.
Is laparoscopy really minimally invasive
1. Laparoscopy, also known as minimally invasive surgery, has evolved significantly over time from early uses of speculums and tubes to modern laparoscopic techniques and robotic surgery.
2. Pneumoperitoneum, usually with carbon dioxide gas, is used to elevate the abdominal wall during laparoscopy and provides better visualization but can cause respiratory acidosis and other physiological effects both locally and systemically.
3. While laparoscopy has advantages over open surgery like reduced pain, blood loss, and recovery time, it also has disadvantages such as the need for specialized equipment and skills and loss of tactile feedback. Extensive training is needed to minimize difficulties.
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Creation of pneumoperitoneum in laparoscopic surgery
Laparoscopic surgery uses carbon dioxide to create pneumoperitoneum during the procedure. Carbon dioxide is commonly used because it is readily available, cheap, suppresses combustion, is easily absorbed by tissues, and is quickly released through respiration. However, the buildup of carbon dioxide can cause hypercarbia, acidosis and hypoxia in the body. It also decreases venous return and cardiac output by exerting pressure on the IVC. This in turn increases arterial pressure and compromises respiratory function by compressing the diaphragm.
anaesthesia in laparoscopic surgery
Laparoscopic surgery involves insufflating the abdominal cavity with gas to provide space for visualization and instruments. Anesthesia aims to minimize the cardiovascular and respiratory effects of pneumoperitoneum and positioning. General anesthesia is most common to protect the airway and control gas flow. Care is taken with patient positioning, gas selection, and addressing risks like gas embolism, pneumothorax, or nerve injury. Special considerations exist for laparoscopy in children, pregnancy, and gasless techniques.
Hemodynamic changes associated with laproscopic surgeries
1) Laparoscopic surgeries involve insufflating the abdominal cavity with carbon dioxide gas to provide space to visualize organs and perform procedures through small incisions.
2) This process leads to several physiological changes including increased heart rate and blood pressure due to compression of veins and stimulation of stress hormones.
3) It also decreases lung volumes and increases airway pressures requiring adjustments to ventilation to maintain normal carbon dioxide levels.
4) Due to these hemodynamic and respiratory effects, careful patient positioning and monitoring is needed along with anesthesia techniques to minimize risks, especially in people with cardiac or pulmonary conditions.
Thoracic anaesthesia
1) The document discusses preoperative evaluation and anesthetic considerations for thoracic surgery patients, with a focus on patients undergoing one-lung ventilation.
2) Key points of preoperative evaluation include assessing pulmonary function, cardiac status, investigating the extent of lung involvement, and optimizing patients with respiratory conditions like COPD.
3) Anesthetic management focuses on techniques for one-lung ventilation using devices like double-lumen endotracheal tubes, as well as strategies for ventilation, induction, and analgesia tailored to patient comorbidities.
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This document discusses preoperative optimization for patients undergoing thoracic surgery. It covers evaluating patients' pulmonary and cardiovascular systems through history, exams, tests like pulmonary function tests and CT scans. Key aspects of preoperative optimization include smoking cessation, using bronchodilators and medications to clear airways, chest physiotherapy, and exercise training. The goal is to reduce postoperative risks by improving lung function and maximizing patient strength and endurance prior to surgery.
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It defines non-invasive positive pressure ventilation (NPPV) and notes that not all ventilators are suitable for each indication. It reviews different interfaces like facial masks, nasal masks, nasal prongs, and others. It also discusses a study comparing the physiologic effects of different interfaces.
The document continues by looking at the rationale for using positive pressure ventilation in cardiogenic pulmonary edema. It reviews several clinical trials that show benefits of NPPV over standard treatment in acute cardiogenic pulmonary edema and respiratory failure
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This document presents a case study of a 55-year-old male patient who was brought to the emergency room in cardiac arrest. The patient had a history of hypertension and ischemic heart disease. Despite resuscitation efforts and treatment in the intensive care unit over several days, the patient's condition deteriorated, developing sepsis, acute kidney injury, and anoxic brain injury. Despite treatment with antibiotics, vasopressors, and renal replacement therapy, the patient could not be revived from cardiac arrest on the fifth day of hospitalization and was declared deceased. The discussion notes that documentation and lab testing could have been improved, and the sepsis protocol was not fully implemented in the emergency room.
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Anaesthesia for laparoscopic surgery from ceaccp journal
Laparoscopic surgery has several benefits over open surgery such as reduced postoperative pain, quicker recovery times, and fewer wound complications. However, the pneumoperitoneum required for laparoscopy can cause physiological changes that require careful management to avoid risks. Specific patient factors, surgical risks, positioning risks, and effects of the elevated abdominal pressure from the pneumoperitoneum like decreased cardiac output and impaired lung function must be addressed with appropriate anesthesia techniques and postoperative monitoring. Close attention is needed for patients at higher risk of complications during and after laparoscopic procedures.
Laparoscopic surgery & it's anaesthetic management
This document provides information on laparoscopic surgery:
- It was first introduced in the 20th century and has since been used for various gynaecological and general surgical procedures.
- The main physiological concerns during laparoscopy are related to insufflation of carbon dioxide including increased intra-abdominal pressure and hypercarbia.
- Laparoscopy has advantages like less pain, shorter recovery time and hospital stay compared to open surgeries.
- Expertise is required due to challenges like impaired touch sensation and inability to have a 3D view.
Ppp pneumoperitoneum
This document discusses techniques for creating pneumoperitoneum during laparoscopic surgery. It describes the closed veress needle technique and open techniques for accessing the abdominal cavity. It covers confirmation of needle placement, alternate puncture sites, and the Hasson and umbilical cicatrix tube methods for open access. Physiological effects of pneumoperitoneum and positioning are summarized, including effects on respiratory, cardiovascular, and renal systems. Potential complications from pneumoperitoneum like injuries, respiratory issues, gas embolism, and cardiovascular effects are outlined. Gases used for insufflation like carbon dioxide, nitrous oxide, helium, and argon are compared.
Anesthesia for laproscopic surgery
This document discusses anaesthesia considerations for laparoscopic surgery. It begins by introducing laparoscopy as a minimally invasive surgical procedure using small incisions and insufflated gas to create space in the abdominal cavity. It then outlines the advantages of laparoscopy like reduced trauma, morbidity, and hospital stay compared to open surgery. The document discusses various anaesthetic techniques for laparoscopy including general anaesthesia, regional anaesthesia and their pros and cons. It also covers hemodynamic, respiratory, and other physiological changes associated with pneumoperitoneum and patient positioning during laparoscopy. Complications related to laparoscopy and their management are also summarized.
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This document discusses anesthesia management for laparoscopic assisted surgery. Some key points include:
- Laparoscopy has advantages over open surgery like shorter hospital stays and faster recovery, but can pose respiratory and cardiovascular risks under anesthesia.
- Maintaining adequate ventilation and oxygenation can be challenging due to absorption of carbon dioxide and positioning effects.
- Gas embolism is a serious risk if gas is directly injected into blood vessels, which can cause hypotension, arrhythmias and death if massive.
- Patient positioning like head-down can increase risks like elevated intracranial pressure and decreased cardiac output that anesthesiologists must manage closely.
anaesthsia for laparoscopic surgery final ppt
This document discusses laparoscopic surgery and anesthesia considerations. It covers the history and benefits of laparoscopic surgery, as well as risks such as CO2 pneumoperitoneum and positioning effects. It provides guidance on insufflator gas selection and management of cardiovascular, respiratory, gastrointestinal and other physiological impacts. Common procedures are listed. Risk factors, complications and their management are outlined.
ANESTHETIC MANAGEMENT LAP CHOLECYSTECTOMY WITH COPD
This document discusses anesthetic considerations for laparoscopic cholecystectomy in a patient with COPD. It provides background on the patient's history and comorbidity of COPD. It then summarizes the key respiratory effects of pneumoperitoneum during laparoscopy including increased airway pressures and changes in ventilation. It also discusses the cardiovascular effects, including a transient increase then decrease in cardiac output due to changes in venous return. Finally, it notes other potential risks such as respiratory acidosis, endobronchial intubation, subcutaneous emphysema, and hypothermia that the anesthesiologist must consider in a patient with COPD undergoing laparoscopic surgery.
Anesthesia for laparoscopic surgery
This document discusses the anesthetic management considerations for laparoscopic surgery. Some key points include: carbon dioxide is used to create pneumoperitoneum during laparoscopy due to its solubility in blood; positioning and carbon dioxide absorption can affect hemodynamics and respiration; careful fluid management and monitoring are important due to physiologic effects; and complications may include subcutaneous emphysema, capnothorax, or cardiovascular issues if not properly managed. A multimodal approach is recommended to minimize complications and optimize outcomes.
Physiologic Changes in Laproscopy
Laparoscopy involves inserting surgical instruments through small incisions in the abdomen while insufflating carbon dioxide gas to elevate the abdominal wall for better visualization. This document discusses the physiological changes that occur during laparoscopy, including cardiovascular, respiratory, renal, and metabolic effects. Cardiovascular changes are initially due to increased venous return but later decreased blood flow from elevated pressures. Respiratory changes involve decreased lung capacity but CO2 is typically eliminated through increased breathing. Renal effects include reduced filtration but are usually mild and reversible.
anaesthesia for lap cholecystectomy
A 41-year-old female presented with right upper quadrant abdominal pain and was diagnosed with symptomatic gallstones and acute cholecystitis. She underwent a laparoscopic cholecystectomy under general anesthesia. General anesthesia was induced and tracheal intubation was performed. Pneumoperitoneum was created and maintained at 12 mmHg during the laparoscopic procedure. The surgery was completed without complications and the patient was extubated and transferred to the recovery unit in a stable condition.
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This document provides an overview of anesthesia considerations for laparoscopic surgeries. It discusses the history of laparoscopy, physiological effects of pneumoperitoneum including on the cardiovascular, respiratory, central nervous and renal systems. It also outlines respiratory complications like subcutaneous emphysema, pneumothorax, gas embolism and their treatment. The effects of patient positioning and conduct of anesthesia are summarized.
Anaesthesia for laparoscopy
This document provides an overview of anaesthesia considerations for laparoscopy. It discusses how carbon dioxide is used to insufflate the peritoneal cavity and create pneumoperitoneum during laparoscopy. This causes various physiological changes including increased systemic vascular resistance, decreased cardiac output, respiratory effects like elevated diaphragm and hypercarbia. It outlines management of hemodynamic and respiratory complications during laparoscopy. Complications discussed include subcutaneous emphysema, pneumothorax, gas embolism. The document provides details on anaesthetic concerns for patient positioning, estimated blood loss and managing cardiovascular instability during laparoscopy.
Is laparoscopy really minimally invasive
1. Laparoscopy, also known as minimally invasive surgery, has evolved significantly over time from early uses of speculums and tubes to modern laparoscopic techniques and robotic surgery.
2. Pneumoperitoneum, usually with carbon dioxide gas, is used to elevate the abdominal wall during laparoscopy and provides better visualization but can cause respiratory acidosis and other physiological effects both locally and systemically.
3. While laparoscopy has advantages over open surgery like reduced pain, blood loss, and recovery time, it also has disadvantages such as the need for specialized equipment and skills and loss of tactile feedback. Extensive training is needed to minimize difficulties.
Laparoscopy in COPD: Anaesthesia
Anesthetic management of a patient with COPD posted for Laparoscopic Cholecystectomy - Case discussion
Creation of pneumoperitoneum in laparoscopic surgery
Laparoscopic surgery uses carbon dioxide to create pneumoperitoneum during the procedure. Carbon dioxide is commonly used because it is readily available, cheap, suppresses combustion, is easily absorbed by tissues, and is quickly released through respiration. However, the buildup of carbon dioxide can cause hypercarbia, acidosis and hypoxia in the body. It also decreases venous return and cardiac output by exerting pressure on the IVC. This in turn increases arterial pressure and compromises respiratory function by compressing the diaphragm.
anaesthesia in laparoscopic surgery
Laparoscopic surgery involves insufflating the abdominal cavity with gas to provide space for visualization and instruments. Anesthesia aims to minimize the cardiovascular and respiratory effects of pneumoperitoneum and positioning. General anesthesia is most common to protect the airway and control gas flow. Care is taken with patient positioning, gas selection, and addressing risks like gas embolism, pneumothorax, or nerve injury. Special considerations exist for laparoscopy in children, pregnancy, and gasless techniques.
Hemodynamic changes associated with laproscopic surgeries
1) Laparoscopic surgeries involve insufflating the abdominal cavity with carbon dioxide gas to provide space to visualize organs and perform procedures through small incisions.
2) This process leads to several physiological changes including increased heart rate and blood pressure due to compression of veins and stimulation of stress hormones.
3) It also decreases lung volumes and increases airway pressures requiring adjustments to ventilation to maintain normal carbon dioxide levels.
4) Due to these hemodynamic and respiratory effects, careful patient positioning and monitoring is needed along with anesthesia techniques to minimize risks, especially in people with cardiac or pulmonary conditions.
Thoracic anaesthesia
1) The document discusses preoperative evaluation and anesthetic considerations for thoracic surgery patients, with a focus on patients undergoing one-lung ventilation.
2) Key points of preoperative evaluation include assessing pulmonary function, cardiac status, investigating the extent of lung involvement, and optimizing patients with respiratory conditions like COPD.
3) Anesthetic management focuses on techniques for one-lung ventilation using devices like double-lumen endotracheal tubes, as well as strategies for ventilation, induction, and analgesia tailored to patient comorbidities.
Preoperative optimization in thoracic surgery
This document discusses preoperative optimization for patients undergoing thoracic surgery. It covers evaluating patients' pulmonary and cardiovascular systems through history, exams, tests like pulmonary function tests and CT scans. Key aspects of preoperative optimization include smoking cessation, using bronchodilators and medications to clear airways, chest physiotherapy, and exercise training. The goal is to reduce postoperative risks by improving lung function and maximizing patient strength and endurance prior to surgery.
Prof. Mridul Panditrao's Peri-operative Management of Jehovah's Witness Patient
Prof. Mridul Panditrao's Peri-operative Management of Jehovah's Witness Patient Prof. Mridul Panditrao
This document describes the peri-operative management of a Jehovah's Witness patient requiring an emergency exploratory laparotomy who refused blood transfusion. It presents a case report of a 65-year-old male who underwent surgery under general anesthesia. Special consent was obtained for no blood transfusion. Intraoperatively, blood loss was replaced with crystalloids and the colloid Tetrastarch (Voluven) to maintain cardiovascular stability given the patient's anemia. The patient had an uneventful recovery without blood transfusion, demonstrating that surgery can be safely performed in Jehovah's Witness patients refusing transfusion through careful pre-operative optimization and use of alternatives to blood loss replacement like colloWhat's hot (20)
Anaesthesia for laparoscopic surgery from ceaccp journal
Anaesthesia for laparoscopic surgery from ceaccp journal
Laparoscopic surgery & it's anaesthetic management
Laparoscopic surgery & it's anaesthetic management
Anaesthesia For Laparoscopic Assisted Surgery Dr. Shailendra
Anaesthesia For Laparoscopic Assisted Surgery Dr. Shailendra
ANESTHETIC MANAGEMENT LAP CHOLECYSTECTOMY WITH COPD
ANESTHETIC MANAGEMENT LAP CHOLECYSTECTOMY WITH COPD
Creation of pneumoperitoneum in laparoscopic surgery
Creation of pneumoperitoneum in laparoscopic surgery
Hemodynamic changes associated with laproscopic surgeries
Hemodynamic changes associated with laproscopic surgeries
Prof. Mridul Panditrao's Peri-operative Management of Jehovah's Witness Patient
Prof. Mridul Panditrao's Peri-operative Management of Jehovah's Witness Patient
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This document discusses controversial issues in non-invasive ventilation. It begins by explaining the normal ventilatory balance and how respiratory failure causes an imbalance. It then discusses how mechanical ventilation can unload the respiratory muscles.
It defines non-invasive positive pressure ventilation (NPPV) and notes that not all ventilators are suitable for each indication. It reviews different interfaces like facial masks, nasal masks, nasal prongs, and others. It also discusses a study comparing the physiologic effects of different interfaces.
The document continues by looking at the rationale for using positive pressure ventilation in cardiogenic pulmonary edema. It reviews several clinical trials that show benefits of NPPV over standard treatment in acute cardiogenic pulmonary edema and respiratory failure
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2) NIV is most effective when started early in respiratory failure before severe acidosis develops. It improves blood gases and respiratory status within 1-2 hours.
3) While NIV success rates are high initially, late failure can still occur in around 23% of patients and is associated with increased mortality if intubation is then required. Close monitoring is needed.
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This study investigated the effects of oral clonidine premedication on hemodynamic changes during laparoscopic cholecystectomy. 100 patients were randomly assigned to receive either oral clonidine 150 micrograms or ranitidine 150 mg 90 minutes before surgery. Heart rate, blood pressure, and the need for antihypertensive treatment were significantly lower in the clonidine group during and after surgery. Postoperative nausea, vomiting, shivering, pain, and sedation were also reduced with clonidine premedication. The results suggest that oral clonidine can provide hemodynamic stability and reduce postoperative complications for patients undergoing laparoscopic cholecystectomy.
NIV in NM Disease
This patient has a history of scoliosis and underwent two surgeries. She presented with shortness of breath, orthopnea, and night cough. Blood tests showed respiratory acidosis and right heart strain. Chest X-ray and echocardiogram revealed scoliosis, dilated right ventricle and atrium, and estimated pulmonary artery pressure of 81.9 mmHg, indicating pulmonary hypertension. She was treated with oxygen but required non-invasive ventilation during sleep due to insufficient breathing in the supine position.
ARDS
1. ARDS is a respiratory condition characterized by diffuse pulmonary edema and hypoxemia that develops rapidly within one week of a known clinical insult.
2. The Berlin Definition from 2011 revised the diagnostic criteria for ARDS, requiring an onset within 1 week of a known clinical insult, bilateral opacities on chest imaging not fully explained by cardiac failure or fluid overload, and a ratio of arterial oxygen partial pressure to fractional inspired oxygen of ≤300 mm Hg for mild ARDS or ≤200 mm Hg for moderate/severe ARDS.
3. Management of ARDS involves mechanical ventilation with low tidal volumes, conservative fluid management to avoid pulmonary edema, and treating the underlying cause of lung injury while minimizing additional lung injury from
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This document provides an overview of non-invasive ventilation (NIV). It discusses the history of NIV, types of ventilators and modes used, interfaces, indications and contraindications. Guidelines are provided on how to start and monitor NIV, including adjusting settings based on patient response. Advantages, disadvantages and complications of NIV are reviewed. Applications of NIV for specific clinical conditions like COPD exacerbation and acute cardiogenic pulmonary edema are covered. The document aims to educate medical professionals on best practices for administering and monitoring patients receiving NIV treatment.
Airway management
The document appears to be notes from an airway management seminar that discusses various topics related to intubation including indications for intubation, preparation for difficult airways and intubation, choices around rapid sequence intubation versus awake intubation, induction agents, and paralysis agents. Case studies are presented and questions are provided about how to manage each case.
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Mule event processing models | MuleSoft Mysore Meetup #47
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Event Link:- https://meetups.mulesoft.com/events/details/mulesoft-mysore-presents-mule-event-processing-models/
Agenda
● What is event processing in MuleSoft?
● Types of event processing models in Mule 4
● Distinction between the reactive, parallel, blocking & non-blocking processing
For Upcoming Meetups Join Mysore Meetup Group - https://meetups.mulesoft.com/mysore/YouTube:- youtube.com/@mulesoftmysore
Mysore WhatsApp group:- https://chat.whatsapp.com/EhqtHtCC75vCAX7gaO842N
Speaker:-
Shivani Yasaswi - https://www.linkedin.com/in/shivaniyasaswi/
Organizers:-
Shubham Chaurasia - https://www.linkedin.com/in/shubhamchaurasia1/
Giridhar Meka - https://www.linkedin.com/in/giridharmeka
Priya Shaw - https://www.linkedin.com/in/priya-shaw
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𝐃𝐢𝐬𝐜𝐮𝐬𝐬 𝐭𝐡𝐞 𝐄𝐏𝐏 𝐂𝐮𝐫𝐫𝐢𝐜𝐮𝐥𝐮𝐦 𝐢𝐧 𝐭𝐡𝐞 𝐏𝐡𝐢𝐥𝐢𝐩𝐩𝐢𝐧𝐞𝐬:
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𝐄𝐱𝐩𝐥𝐚𝐢𝐧 𝐭𝐡𝐞 𝐍𝐚𝐭𝐮𝐫𝐞 𝐚𝐧𝐝 𝐒𝐜𝐨𝐩𝐞 𝐨𝐟 𝐚𝐧 𝐄𝐧𝐭𝐫𝐞𝐩𝐫𝐞𝐧𝐞𝐮𝐫:
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Denis is a dynamic and results-driven Chief Information Officer (CIO) with a distinguished career spanning information systems analysis and technical project management. With a proven track record of spearheading the design and delivery of cutting-edge Information Management solutions, he has consistently elevated business operations, streamlined reporting functions, and maximized process efficiency.
Certified as an ISO/IEC 27001: Information Security Management Systems (ISMS) Lead Implementer, Data Protection Officer, and Cyber Risks Analyst, Denis brings a heightened focus on data security, privacy, and cyber resilience to every endeavor.
His expertise extends across a diverse spectrum of reporting, database, and web development applications, underpinned by an exceptional grasp of data storage and virtualization technologies. His proficiency in application testing, database administration, and data cleansing ensures seamless execution of complex projects.
What sets Denis apart is his comprehensive understanding of Business and Systems Analysis technologies, honed through involvement in all phases of the Software Development Lifecycle (SDLC). From meticulous requirements gathering to precise analysis, innovative design, rigorous development, thorough testing, and successful implementation, he has consistently delivered exceptional results.
Throughout his career, he has taken on multifaceted roles, from leading technical project management teams to owning solutions that drive operational excellence. His conscientious and proactive approach is unwavering, whether he is working independently or collaboratively within a team. His ability to connect with colleagues on a personal level underscores his commitment to fostering a harmonious and productive workplace environment.
Date: May 29, 2024
Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
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anesthsia in laparoscopy
- 1. Dr Giridhar Panpalia Director- Devki hospital Akola
- 2. I want Laparoscopic surgeon !!!!
- 3. Fear Surgical Dissection Anesthetics Anxiolytic as premedicant – Labet et al (anesthesiology 2012)
- 4. Hypertension Pulmonary Edema Macdermott JP Arch Surg 1995; Kawamura RJ Annal J surg 1999
- 6. BP HR Pulmonary Edema ? Obeid F Arch surg 1995; puri GD Brit j Anes 1990
- 8. I told you to start O2 & you Started H2
- 9. Body has 120 liters of CO2 At IAP 15 ; flow of 200ml/hr CO2 absorbed is 20 to 30 ml/hr CO2 Absorption is maximum in first ½ hr Carbonic Acid – Shoulder pain Induces hypothermia – 0.3 C/50 lit of CO2 Shivering Kendall Ap Anesthesilology 1996; Bures EP Brit J Anes 2010
- 10. Liquid Diet – previous day 2 Tab Dulcox – HS No Peglec (It causes Gaseous distention) Liquid diet – Fluid in bowel ; hence easily displaced
- 12. Bronchospasm Secretions Kink
- 15. Alpha2 receptor agonist Noradrenaline Renin Medulary pathways - vasomotor control Stress & serum cortisol Quintin L – Anesthesiology 1991; Hayashi Y Br J Anes 1993
- 17. Route Oral (3-5Microgram) I V(1-2 Microgram) Dose 3 to 5 micro 1 to 2 micro Time 60 to 90 min 10 to 14 min Effectivity Not sure Sure Fix schedule Compulsory Not must Titration Not Possible possible
- 18. Brimacombe J. The advantages of the laryngeal mask airway over the tracheal tube or facemask; A meta analysis. Can J Anaesth 1995; 42: 1019. . Shribman AJ, Smith G, Achola KJ., Cardiovascular and catecholamine responses to laryngoscopy with and without tracheal intubation. Br J Anaesth 1987: 59 : 295 - 9. Pennant JH, White PF; The laryngeal mask airway, its uses in Anaesthesiology. Anesthesiology 1993; 73 : 144 - 63 .
- 19. n =200 Parameters Controls Study p – Value* HR 113.04 ±6.03 109.60 ±8.53 0.0531 SBP 136.56 ±9.30 115.28 ±10.06 0.0001 DBP 94.32 ±6.82 79.52 ±7.35 (Student t test) 0.0001 RPP MAP 15466.08 ±1634.58 108.40 ±7.00 12645.28 ±1568.48 0.0001 91.44 ±6.18 0.0001 There was rise in all the parameters in both the groups but the rise was significantly low in the study group (p < 0.05)
- 20. Parameters Control (ET) Study (LMA) p – Value HR 112.40 ±8.04 106.96 ±16.02 0.0690 SBP 132 ±8.20 112.64 ±8.67 0.0001 DBP 93.76 ±6.72 78.08 ±7.93 0.0001 RPP 14865.92 ±1695.23 11997.68 ±1656.80 0.0001 MAP 106.51 ±6.61 89.60 ±7.01 0.0001 Student t test The parameters in the study group were not significantly increased (p < 0.05)