Objective Retrospective analysis of laparoscopic anesthesia surgery in 5 patients with amyotrophic lateral sclerosis combined with bile duct stones.Methods 5 ALS patients,3 males and 2 females,aged 48-61 years,weight 47-68 kg,and the course of ALS was 6-11 years.Laparoscopic choledocholithotomy and T-tube drainage were required for 1 case of bile duct stones,and 4 cases of laparoscopic cholecystectomy.General anesthesia was selected for all 5 patients.The specific method was to induce anesthesia by intravenous injection of midazolam 0.05 mg/kg,etomidate 0.2 mg/kg,and sufentanil 10 μg after conscious tracheal intubation with the aid of sedative drugs.Anesthesia was maintained by inhalation of 1-3％sevoflurane and infusion of 0.1-0.3μg/(kg·min)of remifentanil.Volume-controlled ventilation,VT 8 ml/kg,I∶E 1∶2,RR 10-14 times/min,and breathing parameters were adjusted to maintain PETCO2 at 35-40 mmHg.The CO2 pneumoperitoneum pressure was set at 12 mmHg.Record and analyze the mean arterial pressure(MAP),pulse oximetry before anesthesia(T0),before skin incision(T1),after pneumoperitoneum filling(T2),before removal of the tracheal tube(T3),and before exiting the chamber(T4).Saturation(SpO2),heart rate(HR),central venous pressure(CVP),and airway peak inspiratory pressure(PpK)and plateau pressure(Pplat)at T1,T2,and T3.Results The anesthesia effect of 5 patients was satisfactory,and the effect evaluation could reach grade Ⅰ.Compared with T0,HR and MAP were significantly decreased at T1(P＜0.05);compared with T1,HR,MAP,PpK,and Pplat were significantly increased at T2(P＜0.05);compared with T2,PpK and Pplat were significantly increased at T3.Significantly decreased(P＜0.05).Conclusions Laparoscopic surgery is safe and feasible in ALS patients under general anesthesia without the use of muscle relaxants.
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