Effects of Carbon Dioxide Insufflation and Body Position on Blood Gas Values in Horses Anesthetized for Laparoscopy

The objective of the study was to describe the effects of carbon dioxide pneumoperitoneum and Trendelenburg position on arterial blood gas values in horses anesthetized for laparoscopy. The study design was a prospective case series using 14 healthy adult horses anesthetized for elective laparoscopic surgery. All horses in the study were maintained under anesthesia with halothane in oxygen with intermittent positive-pressure ventilation. A pneumoperitoneum of 15 mmHg or less was achieved with carbon dioxide, and horses were tilted to a 35-degree Trendelenburg position to allow the completion of laparoscopic cryptorchidectomy (n = 13) or ovariectomy (n = 1). Heart rate, mean arterial pressure, and arterial blood gases were recorded at six time intervals throughout the procedure. Results of the study indicated a pH that decreased and partial pressure of carbon dioxide (PaCO₂) and mean arterial pressure that increased over time and differed significantly from baseline during Trendelenburg position. Partial pressure of oxygen (PaO₂) was significantly lower than baseline after assumption of Trendelenburg position and did not improve on return to normal recumbency and abdominal pressure. As body weight increased, pH and PaO₂ decreased and PaCO₂ increased. We concluded that horses placed in Trendelenburg position have changes that are transient, with the exception of PaO₂. Heavier horses have a greater change in pH, PaCO₂, and PaO₂ than lighter horses during abdominal insufflation and Trendelenburg position. The changes incurred during CO₂ abdominal insufflation and Trendelenburg position are transient, with the exception of a decreased PaO₂. Heavy horses undergoing abdominal insufflation and Trendelenburg position should be closely monitored for critical cardiopulmonary values.     

左肋缘下闭式气腹技术在腹腔镜胆囊切除术中的临床应用（附37例报告）

目的:探讨左肋缘下闭式气腹技术在腹腔镜胆囊切除术中应用的安全性和可行性。方法:回顾性分析因胆囊结石行腹腔镜胆囊切除术37例患者的临床资料。结果:左肋缘下闭式气腹技术成功36例,成功率97%(仅1例因左上腹疤痕而转为脐缘下穿刺气腹技术),平均气腹穿刺时间3min,术中穿刺口出血1～3ml。1例患者因左上腹大网膜与前腹壁粘连有较轻的大网膜挫伤,未见有其它脏器损伤,无手术死亡病例发生。结论:左肋缘下闭式穿刺气腹技术安全、可靠,能作为腹腔镜胆囊切除手术一种可替代的气腹技术。     

牛腰椎放射学研究—牛腰椎X线摄影技术

为使牛腰椎X线摄影存在的困难得以克服,本文采用人工气腹和直肠暗合的方法进行研究。结果表明:采用人工气腹拍摄腰椎右侧位片,可清楚显示L_1～L_5的主要解剖结构,X线照片质量达优、良级标准者为92％(23/25),而无气腹对照片解剖结构模糊,不能分辨,X线照片质量优、良级标准者为0,差、劣级为100％(25/25)。用直肠暗合拍摄腰荐部背腹位照片,可清晰显示L_5～S_1的主要解剖结构,X线照片质量达优、良级标准者为89.24％(15/17)。结果表明采用人工气腹的方法可克服牛腰椎X线摄影的固有困难,为解决应用普通X线机拍到可供诊断的腰椎X照片提供了现实可能。对气腹的安全性也作了观察与讨论。