照顧一位行達文西攝護腺癌根治術病人之麻醉照護經驗

Anesthesia Care Experience for a Patient Undergoing Robotic-Assisted Laparoscopic Radical Prostatectomy

本文描述一位67歲男性罹患攝護腺癌，接受達文西機器手臂輔助攝護腺癌根治術之麻醉照護經驗，因陌生環境與手術焦慮並憂心疼痛，加上長時間頭低腳高及氣腹造成生理負荷，更突顯麻醉照護重要性。護理期間2023年10月02日至10月12日，於手術當天進行麻醉前評估、術中麻醉照護、術後恢復室探訪及麻醉後訪視，藉由觀察、傾聽、直接照護、病例查閱和會談等方式，運用Gordon十一項健康功能型態模式為評估架構，收集資料以確立問題，照護過程中發現病人健康問題有焦慮、潛在危險性手術全期擺位傷害及急性疼痛。運用手術全期麻醉護理：在麻醉前訪視時提供病人相關諮詢、衛教及支持性護理措施以減輕焦慮。術中姿勢擺位給予保護及保暖，有效維護病人手術期皮膚、身體活動度、組織器官功能和生命徵象正常，減少擺位傷害的相關併發症。術後使用疼痛治療、運用減輕疼痛技巧，以減輕疼痛。照護過程中雖然設有麻醉前訪視門診，但礙於工作環境及時間，所能提供的訊息與照護有限，建議可建立麻醉衛教網頁QRcode，提供病人及家屬於麻醉前查閱，可於麻醉前提出討論，適時的給予個別性衛教。希望透過此病人照護分享，提供類似病人手術全期麻醉護理參考，協助病人順利完成手術。

This article describes the anesthetic care experience of a 67-year-old male patient diagnosed with prostate cancer who underwent a robot-assisted radical prostatectomy using the Da Vinci surgical system. The patient experienced heightened anxiety and concern about postoperative pain due to the unfamiliar medical environment and surgical stress. Additionally, the prolonged Trendelenburg position and pneumoperitoneum imposed physiological burdens, further emphasizing the importance of anesthetic care. Nursing period: October 2, 2023 to October 10, 2023, on the day of surgery, preanesthesia assessment, intraoperative anesthesia care, and postoperative recovery room visit were performed. During the post-anesthesia visit, the patient is provided with observation, listening, direct care, case review and interviews. The Gordon 11-item functional health model was used as the assessment framework to collect data to determine. During the care process, it was found that the patient had health problems anxiety, potential risks, and the entire surgery period.Positioning injuries and acute pain. Apply full surgical anesthesia care: provide patients with provide relevant counseling, health education, and supportive care measures to reduce anxiety. intraoperative posture setting protect and keep warm, effectively maintain the patient's skin, body mobility, tissue and organ function during surgerand normal vital signs, reducing complications related to positioning injuries. Postoperative pain management use pain relief techniques to reduce pain. Although there is a pre-anesthesia visit gate during the care process. However, due to the working environment and time, the information and care that can be provided are limited. Establish an anesthesia education webpage QR code, provide patients and their families with access before anesthesia, propose discussions and provide individual health education when appropriate. We hope to provide a reference for anesthesia care during the entire surgical period for similar patients, to assist patients in successfully completing the operation.