Effects of different angle of head low feet high on laparoscopic total hysterectomy patients

Abstract

Objective To observe the different aspects of bed backward on postoperative patients who underwent total laparoscopic hysterectomy. Methods From January to April 2014,sixty patients un-derwent total laparoscopic hysterectomy under general anesthesia,were randomly divided into two groups, with 30 cases in each group. Patients were placed lithotomy position and feel comfortable,begin to anesthe-sia induction and intubation. Observation group：the operation began after pneumoperitoneum and bed by hypsokinesis 10 degrees. Control group：surgical bed be tilted 20 degrees. After surgery,Patients were sent ward and take half supine position to rest,the head of a bed up 30 degrees. The normal vital signs,elec-trocardiogram, blood pressure, heart rate monitor, the airway peak pressure （ Paw ）,＆amp;nbsp;blood gas（pH,PaO2 ,PaCO2 ,SpO2 ,BE,etc）of 30 min（T1）,60 min（T2）after pneumoperitoneum, operation time,complications of surgery anesthesia were observed. Results MAP,HR,Paw of 60 min af-ter pneumoperitoneum in observation group was（99. 2 ±12. 3）,（91. 0 ±12. 6）,（22. 6 ±3. 7）,in control group was（111. 0 ±11. 2）,（102. 2 ± 11. 2）,（25. 4 ± 3. 1）,there were significant differences（P 〈 0. 05）. Blood gas changes in observation group was（7. 37 ±0. 07）,（210. 3 ±46. 1）,（39. 7 ±5. 3）,（98. 9 ±0. 8）, in control group was（7. 28 ±0. 05）,（176. 4 ±46. 2）,（47. 1 ±4. 5）,（96. 1 ±1. 2）,（ -5. 4 ±0. 9）,there were significant differences（P 〈 0. 05）. Complications including severe choking cough,bronchospasm, conjunctival congestion,edema,temporary blindness,nausea,vomiting,regurgitation aspiration asphyxia, tongue after falling respiratory depression,chills,bowel bilges gas agitated for analgesia pump effect was not satisfied,and so on. Complications occure in 10 cases（33% ）of observation group,and 18 cases （60% ）of control group,there was significant difference（P 〈0. 05）. Conclusions Control patients with head low feet high bed retroversion Angle 〈 10 degrees in laparoscopic total hysterectomy,has important significance in preventing its respiratory complications. Key words: Total hysterectomy; Laparoscopy; Head low feet high; Complications; Prevention