Gastrointestinal anesthesia

This is an automatically translated article.

The article was consulted with an Anesthesiologist - General Surgery Department - Vinmec Nha Trang International General Hospital.

1. What is gastrocolic surgery?

Gastrojejunostomy is a surgery to open the junction between the stomach and the jejunostomy if the position between these two segments is obstructed, obstructed (due to factors such as narrow ulcers, tumors, cutting the entire X nerve. )...
Gastroduodenal junction surgery may be indicated in some cases:
The path down to the duodenum is blocked or blocked due to tumors in the duodenum, antrum, ring pancreas, ampulla of Vater... Poor circulation to the duodenum due to X-neurectomy or pyloroplasty. Actively prevent food from passing through the duodenum, often in conjunction with a pylorus closure procedure, in cases where a patient has a large unresectable large duodenal diverticulum or a ruptured duodenum... , this surgery also has some medical situations to consider such as:
Patients with severe systemic condition and multiple diseases at the same time, poor general condition, malnutrition, low blood albumin... adjust blood, electrolytes, albumin... before surgery. There is a tumor that has invaded most of the stomach. Cancer metastasizes to many places and short life...

2. Learn about gastrojejunostomy anesthesia

2.1. What is Gastroenterology Anesthesia? In gastrojejunostomy, anesthesiologists will use endotracheal anesthesia, with or without regional anesthesia, to relieve pain, limit the use of anesthetics during and after surgery. This is a technique of general anesthesia with endotracheal intubation, the purpose of the technique is to control the patient's breathing, provide the best muscle tenderness and pain relief during the surgery as well as the surgery. postoperative recovery time. However, gastrojejunostomy may not be performed in the following cases:
The patient does not consent to anesthesia. Insufficient facilities for anesthesia – resuscitation. The operator is not well versed in anesthetic techniques. 2.2. Preparation before anesthesia Performer: doctors and nurses in the specialty of anesthesiology - resuscitation.
Patient:
Ensure that the patient is thoroughly examined before anesthesia and surgery to detect and prevent possible risks and complications during and after surgery. It is necessary to coordinate with the doctor during the anesthetic process. If necessary, the patient can be sedated the night before surgery to avoid undue anxiety.

2.3. Steps to take before induction of anesthesia in gastrojejunostomy The patient lies on his back and breathes 100% oxygen at least 3-5 minutes before the induction of anesthesia. The nurse will install a monitor and set up the lines. Some patients require pre-anesthesia. Several classes of drugs will be used in this step, including:
Sleeping pills: usually volatile anesthetics and intravenous anesthetics. Painkillers such as sufentanyl, fentanyl, morphine... In case of necessity, some muscle relaxants will be used such as vecuronium, rocuronium, succinylcholine... Check conditions for intubation: The patient must have a deep sleep and qualified muscle relaxation. Endotracheal intubation: there are 2 types of techniques: oral intubation or nasal intubation.

3. Some complications after gastrojejunostomy anesthesia

Sometimes, this technique can cause some complications for the patient due to many reasons, including:
Gastroesophageal reflux: There is digestive fluid overflowing into the oral cavity and airways. Doctors need to immediately drain the fluid, lay the head low, and tilt the head to one side. In addition, it is necessary to monitor to prevent lung infections after surgery. Hemodynamic disorders: Abnormal increase or decrease in blood pressure, arrhythmia. Accidents caused by intubation: occur due to a number of problems such as: not being able to put the endotracheal tube, placing the wrong tube into the stomach, spasm of the larynx - trachea - bronchi, trauma when intubation.. Each problem will have different handling methods. Respiratory complications: the patient needs to be ventilated immediately and provide 100% oxygen, then correct the following cause. In addition, some complications after extubation such as respiratory failure, sore throat - hoarseness, upper respiratory tract inflammation, laryngotracheal stenosis... may also occur.
Gastro-jejunostomy is a difficult surgery that needs to be combined with anesthesia and should be performed by qualified doctors and modern facilities to minimize complications.
Vinmec International General Hospital is a reliable address for examination and treatment of many diseases related to the digestive tract, pancreas, spleen, hepatobiliary, anus and rectum... by surgical method. treatment. Especially with the continuous cultivation of expertise and regular updates on the latest surgical treatments, Vinmec always focuses on applying modern techniques in therapy such as laparoscopic surgery, endoscopic anesthesia. management, ... to ensure the highest treatment effectiveness, minimizing the risk of possible complications.

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