A study on the safety of pneumoperitoneum performed under intravenous anesthesia during robotic rectectomy
10.3760/cma.j.issn.1008-1372.2018.11.012
- VernacularTitle:全凭静脉麻醉下机器人辅助直肠癌手术气腹安全性的研究
- Author:
Li TANG
1
,
2
;
Qian LI
;
Manlin DUAN
;
Dunyi QI
Author Information
1. 221004 徐州医科大学江苏省麻醉学重点实验室
2. 214000 江苏省无锡市锡山人民医院麻醉科
- Keywords:
Rectal neoplasms/SU;
Robotics;
Anesthesia,intravenous;
Pneumoperitoneum,artificial;
Blood gas analysis
- From:
Journal of Chinese Physician
2018;20(11):1651-1655
- CountryChina
- Language:Chinese
-
Abstract:
Objective The purpose of this study was to assess the safety of carbon dioxide pneumoperitoneum on patients during robotic rectectomy.Methods 50 patients [American Society of Anesthesiologists (ASA) physical status Ⅱ,18 and 65 years of age] underwent rectal cancer surgery were selected in our study.According to whether or not robotic assisted surgery was performed,they were divided into a robotic surgery group (group RS) and a laparoscopic surgery group (group LS) by surgical approach,25 patients in each group.All participants were given the same anesthesia protocol.Arterial blood samples 1 ml was obtained from the left radial artery for blood gas analysis to measure the partial pressure of arterial carbon dioxide (PaCO2) and and calculate the arterial-to-end-tidal carbon dioxide pressure difference (Pa-ETCO2) just 10 min after endotracheal intubation (T0),at 30 min(T1),1 h(T2),2 h(T3) after pneumoperitoneum and 30 minutes after release (T4).Meanwhile,the airway peak pressure was monitored.Blood samples (4 ml) extracted at T0,T3 and T4 were centrifuged and measured the serum levels of interleukin (IL)-6 and IL-10 by enzyme linked immunosorbent assay (ELISA).The time to resuscitation,extubation time,intraoperative medication and perioperative adverse events were all recorded.Results Compared with group LS,PaCO2 in the RS group was increased significantly at T1,T2 and T3 after pneumoperitonum and the IL-6 was lower at T4 (P ＜ 0.05).There were no statistically significant differences in Pa-ETCO2,airway peak pressure,IL-10,time to resuscitation,extubation time and the incidence of adverse events between the two groups (P ＞ 0.05).Conclusions It is safe for normal adult patients performed by intravenous anesthesia during robotic-assisted rectal surgery and the inflammatory response is small,which is beneficial to the patient's postoperative recovery.
