摘要
目的总结闭环麻醉给药系统(CLADS)在海上医院执行援外人道主义医疗服务中实施机器人手术麻醉的应用经验及效果。方法“和平方舟”医院船在执行“和谐使命-2024”任务中,麻醉科医师应用“麻醉协奏曲”便携式CLADS对17例患者实施全身静脉麻醉,其中6例患者在国产“海图”手术机器人[上海微创医疗机器人(集团)股份有限公司]辅助下完成泌尿外科手术。回顾性分析6例患者的病历资料,包括基本信息(性别、年龄、身高、体重、BMI、术前诊断、手术类型)、麻醉时间、围手术期血压波动情况、术中低血压和高血压时间占麻醉时间百分比,以及麻醉苏醒时和术后24 h疼痛VAS评分、术后恶心呕吐(PONV)评分,麻醉相关不良事件(苏醒延迟、术后24 h谵妄)的发生情况等。结果6例患者中,男、女各3例,年龄为(49.83±15.92)岁,BMI为(23.44±6.00)kg/m^(2)。术前诊断为右肾囊肿3例,左侧输尿管结石、膀胱肿瘤、前列腺增生各1例;手术类型为机器人辅助右肾囊肿去顶减压术3例、机器人辅助左侧输尿管切开取石术1例、膀胱镜检查术+机器人辅助膀胱部分切除术1例、超声引导下前列腺穿刺活组织检查术+机器人辅助前列腺癌根治术1例。所有患者麻醉诱导平稳,气管插管顺利。术中CLADS监测麻醉维持期间麻醉深度满意、术中血压平稳。麻醉时间为(235.00±107.05)min(范围145~400 min)。术中高血压时间占麻醉时间百分比为0%(0%,1%),术中低血压时间占麻醉时间百分比为3%(1%,9%),平均低血压时间为(10.3±8.1)min。术后患者均苏醒顺利,未发生苏醒延迟和谵妄等麻醉相关不良事件,术后疼痛VAS评分和PONV评分均≤2分。结论CLADS能辅助麻醉科医师完成舰船环境下机器人泌尿外科手术的麻醉,维持满意的麻醉深度和循环稳定。
Objective To summarize clinical experience and outcomes of a closed-loop anesthesia delivery system(CLADS)in robotic surgery during humanitarian medical missions on a hospital ship.Methods During the“Harmony Mission-2024”,a total of 17 surgeries were performed under general anesthesia assisted by the portable CLADS aboard the“Peace Ark”Hospital Ship,including 6 urological procedures conducted with the domestically developed“Hai Tu”surgical robotic system.Medical records of the 6 patients were retrospective analyzed,including sex,age,height,weight,body mass index(BMI),preoperative diagnosis,surgical types,anesthesia duration,percentages of intraoperative hypertension and hypotension relative to total anesthesia time,visual analogue scale(VAS)score,post operative nausea and vomiting(PONV)score,and anesthesia-related adverse events.Results There were 3 males and 3 females with a mean age of(49.83±15.92)years and a mean BMI of(23.44±6.00)kg/m^(2).Preoperative diagnoses included right renal cyst(n=3,treated by windowing decompression),left ureteral stone(n=1,treated by robot-assisted ureterolithotomy),bladder tumor(n=1,cystoscopy+robot-assisted bladder partial excision),and benign prostatic hyperplasia(n=1,ultrasound-guided biopsy+robot-assisted radical prostatectomy).All patients achieved smooth anesthesia induction and tracheal intubation.The CLADS continuously monitored anesthesia depth,blood pressure,and heart rate,ensuring optimal anesthesia depth and hemodynamic stability.The mean anesthesia duration was(235.00±107.05)min(range:145-400 min).Intraoperative hypertension accounted for 0%(0%,1%)of anesthesia time,while hypotension accounted for 3%(1%,9%),with a mean duration of(10.30±8.10)min.All patients recovered uneventfully without delayed awakening,delirium,or other anesthesia-related complications.Postoperative VAS scores and PONV scores were≤2.Conclusion The CLADS can effectively assist anesthesiologists in managing anesthesia for urological robotic surgeries aboard hospital ship,maintaining satisfactory anesthesia depth and circulatory stability.
作者
代静雅
缪雪蓉
兰杨
廖清贵
潘超
贾慧
魏祥
郑栋煜
袁红斌
傅海龙
DAI Jingya;MIAO Xuerong;LAN Yang;LIAO Qinggui;PAN Chao;JIA Hui;WEI Xiang;ZHENG Dongyu;YUAN Hongbin;FU Hailong(Department of Anesthesiology,the Second Affiliated Hospital of Naval Medical University,Shanghai 200003,China;不详)
出处
《上海医学》
2025年第10期623-629,共7页
Shanghai Medical Journal
基金
上海市科学技术委员会科技计划项目(20Y11909500)
海军军医大学第二附属医院医学专项(2024DZXYY-305)。
关键词
闭环麻醉给药系统
静脉麻醉机器人
海上医院
机器人手术
Closed-loop anesthesia delivery system
Intravenous anesthesia robot
Hospital ship
Robotic surgical procedures
