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Abstract：
The development and adoption of minimally invasive techniques has revolutionized various surgical disciplines and has also been introduced into cardiac surgery, offering patients less invasive options with reduced trauma and faster recovery time compared to traditional open-heart procedures with sternotomy. This article provides a comprehensive overview of the anesthesiologic management for minimally invasive cardiac surgery (MICS), focusing on preoperative assessment, intraoperative anesthesia techniques, and postoperative care protocols. Anesthesia induction and airway management strategies are tailored to each patient\'s needs, with meticulous attention to maintaining hemodynamic stability and ensuring adequate ventilation. Intraoperative monitoring, including transesophageal echocardiography (TEE), processed EEG monitoring, and near-infrared spectroscopy (NIRS), facilitates real-time assessment of cardiac and cerebral perfusion, as well as function, optimizing patient safety and improving outcomes. The peripheral cannulation techniques for cardiopulmonary bypass (CPB) initiation are described, highlighting the importance of cannula placement to minimize tissue as well as vessel trauma and optimize perfusion. This article also discusses specific MICS procedures, detailing anesthetic considerations and surgical techniques. The perioperative care of patients undergoing MICS requires a multidisciplinary approach including surgeons, perfusionists, and anesthesiologists adhering to standardized treatment protocols and pathways. By leveraging advanced monitoring techniques and tailored anesthetic protocols, clinicians can optimize patient outcomes and promote early extubation and enhanced recovery.
摘要：
微创技术的发展和采用,使各种外科学科发生了革命性的变化,也被引入心脏外科,与传统的胸骨切开心脏直视手术相比，为患者提供更少侵入性的选择，减少创伤和更快的恢复时间。本文全面概述了微创心脏手术（MICS）的麻醉管理，专注于术前评估，术中麻醉技术,和术后护理方案。麻醉诱导和气道管理策略是根据每个患者的需求量身定制的，一丝不苟地注意保持血流动力学稳定和确保充分的通气。术中监测,包括经食管超声心动图（TEE），经过处理的脑电图监测，和近红外光谱(NIRS)，便于实时评估心脏和大脑灌注，以及功能，优化患者安全并改善预后。描述了用于体外循环（CPB）启动的外周插管技术，强调插管放置的重要性，以尽量减少组织和血管创伤和优化灌注。本文还讨论了具体的MICS程序，详细介绍麻醉注意事项和手术技术。接受MICS的患者的围手术期护理需要包括外科医生在内的多学科方法，灌注主义者,和麻醉医师坚持标准化的治疗方案和途径。通过利用先进的监测技术和量身定制的麻醉方案，临床医生可以优化患者预后,促进早期拔管和加快康复.
