Endotracheal anesthesia for total colectomy

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

A colectomy is a surgical operation that removes part or all of the large intestine, focusing on the damaged or diseased parts of the large intestine. This is a major surgery, usually indicated after conservative treatments have failed to improve health.
Rectectomy - colectomy is a common treatment for a number of conditions such as:
Diverticulosis: the formation of small pouches on the side of the colon wall. Inflammatory bowel disease, colitis, Crohn's disease... Intestinal damage due to external trauma, large bowel perforation, intestinal bleeding... Polyps (the formation of appendages) – a condition that occurs precancerous conditions, especially in the group of subjects with familial polyposis syndrome. Large bowel obstruction. Colon and rectal cancer.

Currently, colectomy - rectum is carried out by 2 methods. Doctors will choose a surgical method depending on the patient's health conditions as well as disease status, including:
Open surgery: the doctor will make a long incision on the abdomen and directly remove the damaged large intestine. / has a previously diagnosed illness. Laparoscopy: in this surgery, the doctor will make many small incisions on the abdomen and use a special scope as well as some instruments to remove the previously indicated large intestine. In addition, the doctor will often make a small incision to remove the specimens from the abdomen.

The answer is yes, both colectomy - rectal resection require general anesthesia during the surgery to prevent pain from reaching the patient's body, ensuring maximum muscle relaxation, Soft muscles help surgeons manipulate easily and conveniently. Usually, the anesthetic technique indicated for this type of surgery is endotracheal anesthesia combined with regional anesthetic methods to help reduce pain during and after surgery better, reducing the amount of anesthetic needed. .
This technique will give general anesthesia and along with intubation for the purpose of controlling the patient's airway during surgery as well as the postoperative recovery period.

Regarding the steps, the anesthetic process will be performed in turn according to the following procedure:
3.1. General Procedure: Place patient in supine position and receive 100% oxygen for at least 5 minutes prior to induction of anesthesia. Install the monitors and set up the transmission. If necessary, perform additional pre-anesthesia operations such as using prophylactic and antiemetic drugs, drugs to reduce stomach acid, drugs to reduce secretions... 3.2. Initiating anesthesia Using sleeping pills such as intravenous anesthetics, volatile anesthetics... Pain relievers: morphine, sufentanil, fentanyl... Muscle relaxants. Check conditions for intubation: the patient must sleep deeply and have sufficient muscle relaxation. 3.3. Endotracheal intubation Usually done by one of 2 techniques:
Intubation by mouth. Intubation through the nose. Anesthetize the pain relief area if indicated. 3.4. Maintaining anesthesia The patient under anesthesia will be monitored and evaluated regularly throughout the surgery. To maintain the patient's anesthesia, doctors will:
Continue using intravenous anesthetics, volatile anesthetics, muscle relaxants and pain relievers... depending on specific conditions. Control the breathing process with a specialized anesthetic machine. Complementary and monitoring response to combined pain therapies (Regional anesthesia).

Before performing surgery, the patient needs to have a pre-anaesthetic examination at least a few days before surgery. This visit will include an examination, evaluation, additional laboratory results, blood tests as well as a general physical examination. Depending on age, general health condition and disease severity, doctors will decide whether the patient is eligible to perform surgery or not.
After surgery is indicated, the night before the surgery and the morning of the surgery, the patient needs to bathe with an antiseptic solution.
It is also important to note that the colon is an area that stores waste products and is a favorable environment for bacteria to grow, so if they enter the abdomen during surgery, it can cause serious infection. .

Therefore, the following factors should be kept in mind to prevent the above risk:
Use of oral antibiotics for a few days before surgery and/or prophylactic antibiotics before surgery. Colon cleansing. In the 2-3 days before surgery, the patient must eat soft and liquid foods to help the digestive system work quickly. Within 24 hours before surgery, the patient only drank sugar water and from midnight before surgery, the patient had to fast completely. The patient must also take oral medication before the day of surgery. At that time, the patient needs to be hospitalized and given fluids to avoid dehydration due to diarrhea. In short, colectomy is a major surgery and to make sure the patient can pass as easily as possible, doctors need endotracheal anesthesia before performing the surgery. . In addition, patients also need to adhere to pre-operative preparation regimens to ensure effectiveness and safety, minimizing risks/complications that may occur after surgery.
Currently, Vinmec International General Hospital has brought a system of modern machinery, equipment, and standard surgical anesthetics to the examination, diagnosis, anesthesia and treatment of diseases, including: endotracheal anesthesia, endoscopic colorectal surgery. With leading experts in the field, it will bring optimal treatment results, and at the same time minimize dangerous complications that may occur to the patient.