小儿电视胸腔镜手术的麻醉管理  

The Management of Anesthesia in Children with VATS

作　　者：樊小兵[1] 任永功[1] 黄小朋[1] 李涵葳[1] 王正[1] 

机构地区：[1]暨南大学医学院第二附属医院,广东深圳518020

出　　处：《咸宁学院学报（医学版）》2004年第2期113-114,117,共3页Journal of Xianning Univarsity(medical Sciences)

摘　　要：目的探讨单腔气管导管 ,低潮气量用于婴幼儿电视胸腔镜手术 (VATS)的可行性和安全性。方法选择 2 5例平均年龄 6 .7岁、体重 2 0 .1kg的胸部疾病患儿实行VATS。术前肌注阿托品 0 .0 2mg /kg、苯巴比妥钠 3～5mg/kg ,以芬太尼 2 .0 μg/kg、异丙酚 2mg/kg、万可松 70～ 80 μg/kg快速诱导麻醉 ,经口腔明视插入单腔气管导管。胸腔镜进入胸腔后 ,改用 4～ 6ml/kg潮气量机械通气。结果 2 5例患儿术中麻醉维持平稳 ,血氧饱和度和呼气末二氧化碳监测正常 ,手术经过顺利。结论单腔气管导管插管低潮气量用于小儿VATS有操作简单 ,管理容易 ,安全可靠等优点。Objective To investigate the availability and safety of single-lumen bronchial intubation and low tidal volume employed in children with Video-assisted thoracoscopic surgery (VATS).Methods 25 children suffering thoracic disease with average age 6.7 and body weight 20.1kg were performed VATS. Atropine 0.02mg/kg and sodium luminal 3～5mg/kg were administered intramuscularly for premedication. Anesthesia was rapidly induced by iv administration of 2μg/kg fentanyl, 2mg/kg propofol and 70～80μg/kg norcuron and then a single-lumen bronchial tube was inserted orally. After the thoracoscope was introduced into the pleural cavity, the children were mechanically ventilated by an altered tidal volume 4～6ml/kg.Results All 25 children obtained a steady maintenance of anesthesia, normal monitoring of SpO 2 and PetCO 2 and successful operation. Conclusion The usage of single-lumen bronchial intubation and low tidal volume in children have advantages of safety, reliability, simple operation and easy management.

关 键 词：电视胸腔镜手术 麻醉管理 胸腔视野 单腔气管插管 潮气量 小儿 

分 类 号：R726.55[医药卫生—儿科]