General anaesthesia for laparascopic adrenalectomy.

摘要

Surgical treatment of adrenal disorders is increasingly performed underlaparascopic approach. Both pneumoperitoneum and adrenal tumour manipulation may induce haemodynamicvariations. The aim of this study was to compare the inhalational and intravenous anaesthetic managementfor laparascopic adrenalectomy. Between 1977 and 1999 there were performed 28 laparascopic adrenalectomies.At patients with functioning adenoma and hypertension the anaesthesia was maintained with isofluranein 8 cases and sevoflurane in 6 cases, et 14 patients with non-functioning adrenal masses with propofoland fentanyl (TIVA). In addition to the circulatory and respiratory monitoring there were made seriallaboratory determinations (acid-base state, serum potassium, blood glucose) during the operation. Onthe basis of measured parameters isoflurane and sevoflurane anaesthesia proved to be favourable in caseof functioning adrenal adenoma and TIVA with propofol and fentanyl in case of non-functioning adenoma.