21例非停跳冠脉搭桥术的麻醉处理  

Practical anesthesia management of off-pump coronary artery bypass grafting in 21 cases

作　　者：周咏华[1] 孙建良[1] 陆雅萍[1] 周煦燕[1] 袁孝忠[1] 俞丹红[1] 沈徐[1] 

机构地区：[1]嘉兴医学院附属嘉兴市第一医院麻醉科,浙江嘉兴314000

出　　处：《临床医学》2008年第5期26-27,共2页Clinical Medicine

摘　　要：目的介绍非体外循环下不停跳冠脉搭桥术（OPCABG）的麻醉处理。方法择期OPCABG患者21例,均采用全麻复合控制性降压麻醉。以依托咪酯、咪唑安定、芬太尼、罗库溴铵诱导插管,瑞芬太尼和异丙酚泵注维持麻醉。术中监测血流动力学各项指标,应用血管活性药物进行有效的心血管功能支持。术后常规呼吸支持和异丙酚镇静。结果21例患者分别搭桥2~4支,全部患者麻醉手术经过均顺利,围术期无严重并发症发生,术后第1天均顺利拔管转入普通病房。结论充分的术前准备和术前评估,严密的术中监测及良好的沟通,围术期维持心肌氧供需平衡和适当的麻醉深度,术后常规呼吸支持和监测是OPCABG麻醉处理的关键。Objective To introduce practical anesthesia management of off- pump coronary artery bypass grafting （OP- CABG）. Methods Twenty - one patients underwent selective OPCABG received etomidate, midazolam and fentanyl - based general anesthesia and induced low pressure. Intubation were facilitated with rocurorium. General anesthesia was maintained with remifentanil and propofol infusing. Hemodynamics data was monitored during the anesthesia. Cardiovascular function was supported by vasoactive agent. All the patients were ventilated and sedated post - anesthesia. Results All the patients went through anesthesia smoothly. The number of grafts was 2 -4 respectively. No serious complications happened perisurgically. All the patients were extubated and transferred to gerenal ward in the first day post anesthesia. Conclusion Adequate preparation and evaluation, intensive monitoring and good communication, appropriate depth of anesthesia and myocardium oxygen delivery - consumption relationship, all contribute to successful anesthesia.

关 键 词：非体外循环下冠脉搭桥术 麻醉处理 症状 临床分析 

分 类 号：R614[医药卫生—麻醉学]