Optimizing Anesthetic Management for Laparoscopic Surgery: A Comprehensive Review.

Abstract

Laparoscopy, as the most frequently chosen surgical technique in the world, carries specific complications and distinctions in anesthetic management. Complications of laparoscopy, particularly perceptible as disorders of the physiology of the cardiovascular, respiratory, and nervous systems, are caused by the specific technical conditions required for this type of operation. To facilitate surgical access and to clarify the surgical field, it is necessary to create a splenic emphysema, consisting of filling the peritoneal cavity with carbon dioxide (CO₂). This results in an increase in intra-abdominal pressure (IAP) and increased diffusion of CO₂ into the blood, causing a state of hypercarbia. The impact of these disturbances is of great importance in the pathological functioning of the above-mentioned organ systems. The anesthetist, in addition to the need to induce a state of general anesthesia, must be aware of and understand the pathological impact of increased intracranial pressure (ICP) and hypercarbia to adjust patient monitoring accordingly and implement appropriate treatment targeting the specific complications occurring during laparoscopy. Complications and contraindications important from the anesthetist's point of view are also described. The 51 articles and reference texts were used for this purpose, which, combined with the authors' knowledge and experience, is intended to be a valuable resource for use by anesthesiology staff. This article aims to explain the effects of laparoscopy on human physiology and to compare and contrast methods of airway management, mechanical ventilation, the type of muscle relaxation used, and postoperative management in patients undergoing laparoscopic surgery.