Seminar on laparoscopic surgery and its anaesthetic consideration
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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.
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1) Preoperative hypertension is common and increases the risk of perioperative complications, however well-controlled hypertension may not need surgery postponement.
2) Isolated systolic hypertension over 180 mmHg and high pulse pressure over 80 mmHg are associated with increased risk and reasonable to postpone surgery.
3) Left ventricular hypertrophy and diastolic dysfunction from long-standing hypertension increase perioperative risk and require careful fluid management during surgery.
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- Outcomes being greatly improved compared to remaining on dialysis.
- Types of donors including living and cadaveric.
- Anesthesia goals for living donors focusing on safety.
- Evaluation, induction, maintenance and monitoring for recipients.
- Positioning, fluid management and hemodynamic goals.
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This document discusses various methods of labor analgesia. It begins by outlining the objectives and introducing the stages of labor and physiology of pain. It then summarizes non-pharmacological methods like psychoprophylaxis and TENS. Various pharmacological methods are discussed including inhalational analgesia, systemic opioids, and regional techniques like epidural analgesia, combined spinal epidural, and walking epidural. Epidural analgesia is described as the gold standard, and optimal epidural regimens, administration techniques, and monitoring are outlined.
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- Anesthesia goals for living donors focusing on safety.
- Evaluation, induction, maintenance and monitoring for recipients.
- Positioning, fluid management and hemodynamic goals.
Physiological Changes in Pregnancy and Its Anaesthetic Implications.
This document summarizes the physiological changes in pregnancy and their implications for anesthesia. It discusses how pregnancy causes increased blood volume, cardiac output, oxygen consumption and acidity levels. These changes can cause issues like supine hypotension syndrome when the mother lies on her back. The document also covers respiratory, coagulation, gastrointestinal and central nervous system changes in pregnancy and how they impact drug dosages and anesthesia techniques. Special considerations are discussed for intubation, regional anesthesia and placental drug transport.
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→ Discuss indications of general anesthesia for operative delivery
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This document discusses guidelines for anaesthesia for non-obstetric surgery during pregnancy from the American College of Obstetricians and Gynecologists. It emphasizes that no currently used anaesthetic agents have been shown to cause teratogenic effects in humans. It also stresses the importance of maintaining uteroplacental blood flow and oxygen delivery to avoid fetal hypoxia. The roles and goals of the anaesthesiologist are to provide safe anaesthesia for both the mother and fetus by considering the physiological changes of pregnancy and modifying the anaesthetic technique accordingly.
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The document provides information on the management of intra-operative bronchospasm, including risk factors, triggers, diagnosis, prevention, and treatment approaches. Bronchospasm can be caused by airway irritation or anaphylaxis and presents with signs of wheezing, increased airway pressures, and falling oxygen saturation. Differential diagnoses must be ruled out. Management involves deepening anesthesia, administering bronchodilators, optimizing ventilation, and considering anaphylaxis or postponing surgery. A case example demonstrates treatment of bronchospasm potentially caused by succinylcholine-induced anaphylaxis.
Awake intubation distribution
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caudal anesthesia.pdf
Caudal anesthesia involves injecting local anesthetic into the caudal canal of the sacrum to provide pain relief below the umbilicus. It can be used alone or with general anesthesia for surgeries involving the perineum, anus, rectum, or lower extremities. The technique involves identifying the sacral hiatus and inserting a needle, with ultrasound or fluoroscopy guidance available. Potential complications include dural puncture, nerve injury, and local anesthetic toxicity. The level of pain relief varies significantly among patients.
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- Patient is unconscious and has regular breathing
- Pupils are dilated and fixed
- Reflexes like eyelash, swallowing are lost
- Surgery can be safely performed during this stage
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Anesthesia 5th year, 6th & 7th lectures (Dr. Gona)
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Similar to Seminar on laparoscopic surgery and its anaesthetic consideration
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 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__management_of_Laparoscopic__Surgery.pptx
This document discusses the anesthetic considerations and complications related to laparoscopic surgeries. It notes that laparoscopy requires increased intra-abdominal pressure from insufflation of carbon dioxide gas, which can affect cardiovascular and respiratory physiology. The anesthesiologist must monitor for and manage increases in carbon dioxide levels as well as potential complications like gas embolism, pneumothorax, subcutaneous emphysema, and hemodynamic changes due to patient positioning. Proper preoperative evaluation, intraoperative monitoring, and postoperative care can help prevent or address issues arising from laparoscopic procedures.
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.
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.
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.
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.
shalini laparo [Autosaved].pptx
Laparoscopic surgery involves inserting specialized tubes into the abdominal cavity to perform minimally invasive surgery. Carbon dioxide gas is used to insufflate the abdomen and create pneumoperitoneum. This causes physiological changes including increased heart rate and blood pressure due to hypercapnia and raised intra-abdominal pressure. It can also decrease lung volumes and compliance. The anesthesiologist must carefully manage ventilation and monitor for potential complications like subcutaneous emphysema, capnothorax, and venous gas embolism during laparoscopic surgery. Patient positioning, temperature control, and multimodal postoperative pain management are also important considerations for the anesthesiologist.
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.
How do I safely ventilate my patient inOT.pptx
There are several key points regarding safe ventilation of patients in the operating theatre:
1. Mechanical ventilation can cause harm if not done properly, so the goal is to open just enough lung to provide adequate oxygen while avoiding ventilator-induced lung injury.
2. Large tidal volumes, low PEEP, and high FiO2 have been shown to increase the risk of postoperative pulmonary complications, so a lung protective strategy is recommended.
3. Surrogates like plateau pressure, driving pressure, and static compliance can help assess lung stress and strain in the absence of direct measurements and guide ventilation settings to prevent overdistention and volutrauma.
Congenital diaphragmatic hernia
Congenital diaphragmatic hernia is a neonatal emergency that occurs when abdominal organs push into the chest cavity through a defect in the diaphragm. It has traditionally had high mortality rates, but preoperative stabilization techniques including nitric oxide, high frequency ventilation, ECMO, and permissive hypercapnia have reduced mortality to under 75%. The presentation depends on when during fetal development the hernia occurred. Treatment involves preoperative stabilization followed by surgical repair once stabilized, with postoperative care focused on managing pulmonary hypertension and hypoplasia. Prognosis depends on the degree of lung and heart hypoplasia and presence of other defects.
Thoracic ana.2022
This document discusses thoracic anesthesia and one lung ventilation. It begins with the aims and goals of thoracic anesthesia, which include minimizing cardiac depression and pulmonary pressures/resistance while ventilating one lung. It then covers topics like the lateral decubitus position, effects of anesthesia/paralysis, techniques for one lung ventilation including double lumen tubes, and the physiological impacts of the lateral position. Hazards of techniques like double lumen tubes are also addressed. The document provides detailed information on evaluating and preparing patients as well as performing thoracic anesthesia.
Anesthesia-in-Laparoscopic-Surgery (2).pdf
World Laparoscopy Hospital provides learning by doing. It provides real-world laparoscopic surgery experience by allowing the trainee to get hands-on directly with whatever surgeons are learning and developing a sense of empowerment. After taking this laparoscopic training course, surgeons and gynecologists can perform laparoscopic surgery them self on their patients with confidence.
Anesthesia-in-Laparoscopic-Surgery.pdf
The anesthetic problems during minimal access surgery
are related to the cardiopulmonary effects of pneumoperitoneum, carbon dioxide (CO2) absorption, extraperitoneal
gas insufflation, venous embolism, and inadvertent injuries
to intraabdominal organs. Optimal anesthetic care of
patients undergoing laparoscopic surgery is very much
important. Good anesthetic techniques facilitate riskfree surgery and allow early detection and reduction of
complications.
In young patients, fit for diagnostic laparoscopy, general
anesthesia is the preferred method and does not impose
any increased risk. Adequate anesthesia and analgesia
are essential and endotracheal intubation and controlled
ventilation should be considered. The pneumoperitoneum
can be created safely under local anesthesia provided that
the patient is adequately sedated throughout the procedure.
For successful laparoscopy under local anesthesia, intravenous (IV) medication for sedation should be given
Anesthesia in Laparoscopic Surgery
The anesthetic problems during minimal access surgery are related to the cardiopulmonary effects of pneumoperitoneum, carbon dioxide (CO2) absorption, extraperitoneal
gas insufflation, venous embolism, and inadvertent injuries to intraabdominal organs.
Bronchopleural fistula anesthetic concerns
A 15-year-old male was brought to the emergency department 19 days after sustaining a chest injury from a tractor steering wheel. He had pain and breathlessness after the injury and was found to have a near complete transaction of the right main bronchus and bronchopleural fistula. He underwent initial treatment including intercostal drainage placement.
On examination, he was conscious but had absent air entry on the right side of the chest and straw colored fluid was found in the right intercostal drainage tube. Imaging showed a right pneumothorax with collapsed lung and absent bronchopulmonary markings. A bronchopleural fistula was diagnosed. Treatment options for bronchopleural fistulas were discussed.
laparoscopy anaesthesia.J.pptx
Laparoscopic surgery requires insufflation of carbon dioxide gas to create a pneumoperitoneum. This causes physiological changes including increased systemic vascular resistance, decreased cardiac output, hypercarbia, and respiratory effects like elevated diaphragm and reduced lung volumes. Care must be taken to monitor for complications from gas absorption and embolism. The anesthesiologist must carefully manage hemodynamics, ventilation, and position the patient to minimize risks during laparoscopic procedures.
BRONCHOPLEURAL fistula pptx.............
A 15-year-old male was brought to the emergency department 19 days after sustaining a chest injury from a tractor steering wheel. He had pain and breathlessness after the injury and was found to have a near complete transaction of the right main bronchus with bronchopleural fistula (BPF). On examination, he had absent breath sounds on the right side and a chest tube draining fluid. A CT scan showed a right pneumothorax with collapsed lung. BPFs can be classified based on their airflow patterns and location. Treatment depends on the size and chronicity of the fistula and includes medications, endobronchial techniques, surgery, or a combination. The goal of anesthesia management is to optimize
Complications of pulmonary surgery
Postoperative pulmonary complications are pulmonary abnormalities that occur after surgery and negatively impact a patient's clinical course. Surgical factors like the incision site, anesthesia duration and type, and postoperative pain management are more influential than patient factors. Risks of postoperative pulmonary complications increase with surgical site, prolonged surgery, underlying lung disease, smoking history, obesity, poor nutrition, older age, and inadequate nursing staffing. Common complications include hypoxemia, atelectasis, and respiratory failure. Hypoxemia and atelectasis are common due to anesthesia effects and can persist for days. Respiratory failure ranges from mild hypoxemia to life-threatening acute respiratory distress syndrome.
ANAESTHESIA FOR LAPAROSCOPIC SURGERIES.pptx
Anaesthetic implication of laparoscopic surgery will help medical students as well as doctors performing safe anaesthesia practice in laparosc opic surgery.
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Seminar on laparoscopic surgery and its anaesthetic consideration
- 11. CARDIOVASCULAR CHANGES These changes are characterized by : Decreased cardiac output Elevation of arterial pressure and pulmonary vascular resistance HR may decrease or increase