Anesthetic considerations for laser, laparoscopy, and thoracoscopy procedures

Abstract

Laser surgery and laparoscopy are two relatively new surgical techniques gaining popularity in veterinary medicine, which require special consideration when being performed on the anesthetized patient. For laser surgery, consideration must be given to the possibility of atmospheric contamination, inappropriate energy transfer, eye injury, perforation of a vessel or anatomic structure, perforation of the endotracheal tube, and fire. The primary concern with laparoscopy and thoracoscopy is the creation of a pneumoperitoneum or pneumothorax, which can result in (1) hypercarbia and inadequate ventilation, (2) poor cardiac output and systemic blood pressure, and (3) gas embolism. To minimize complications, patients should be placed on positive pressure ventilation, be well hydrated before and during the procedure, and be thoroughly monitored (ECG, capnography, pulse oximetry.