Jacob Rosenberg1, Thomas Fuchs-Buder2. 1. Department of Surgery D, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Herlev, Denmark. jacob.rosenberg@regionh.dk. 2. Department of Anaesthesia, CHU de Nancy, Hôpitaux de Brabois, Nancy, France.
Abstract
BACKGROUND: During laparoscopic surgery, it is important to secure adequate surgical workspace. This can be obtained by improved neuromuscular blockade during the procedure. However, there are a lack of knowledge about neuromuscular blockade in anaesthesia in general among surgeons and a lack of knowledge about surgical technical issues among anaesthesiologists. METHODS: The issues are discussed based on the available literature. RESULTS: Knowledge between the two specialities is highly relevant and is typically lacking. There are data to support the fact that the abdomen may be tense although there are clear signs of neuromuscular blockade on the TOF-watch. This situation can be easily explained by the pharmacodynamics of the neuromuscular blocking agents, and it means that the anaesthesiologist is overestimating the level of blockade. CONCLUSIONS: There are potential problems during laparoscopic surgery where a better communication and collaboration between surgeon and anaesthesiologist may be beneficial for patient outcome.
BACKGROUND: During laparoscopic surgery, it is important to secure adequate surgical workspace. This can be obtained by improved neuromuscular blockade during the procedure. However, there are a lack of knowledge about neuromuscular blockade in anaesthesia in general among surgeons and a lack of knowledge about surgical technical issues among anaesthesiologists. METHODS: The issues are discussed based on the available literature. RESULTS: Knowledge between the two specialities is highly relevant and is typically lacking. There are data to support the fact that the abdomen may be tense although there are clear signs of neuromuscular blockade on the TOF-watch. This situation can be easily explained by the pharmacodynamics of the neuromuscular blocking agents, and it means that the anaesthesiologist is overestimating the level of blockade. CONCLUSIONS: There are potential problems during laparoscopic surgery where a better communication and collaboration between surgeon and anaesthesiologist may be beneficial for patient outcome.
Entities:
Keywords:
Anaesthesia; Laparoscopy; Learning; Neuromuscular blockade; Surgery
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