七氟醚诱导复合异丙酚维持用于小儿先心封堵术的临床观察  

Sevoflurane combined with propofol to maintain clinical observation for transcatheter closure of congenital heart disease

作　　者：凌中义[1] 张新疆 

机构地区：[1]武汉亚洲心脏病医院麻醉科,湖北武汉430022 [2]新疆博州人民医院麻醉科,新疆博州833400

出　　处：《中医学报》2013年第B08期105-106,共2页Acta Chinese Medicine

摘　　要：目的：观察七氟醚吸入诱导、异丙酚维持用于小儿先心病介入封堵麻醉的临床效果。方法：小儿先心介入封堵手术255例，ASAⅠ～Ⅱ级，入室面罩吸纯氧6L／min＋8％七氟醚诱导，意识消失后停用七氟醚。开放外周静脉，静注长托宁0．01mg／kg，给予异丙酚5～10mg／kg／h持续静脉泵入。记录吸入七氟醚前后，泵注异丙酚5min时、15min时，HR、MAP、SPO2值，记录患儿吸入七氟醚后入睡时间（s），麻醉时间（min）及苏醒时间（min），术后随访患儿有无缺氧发作、恶心呕吐。结果：患儿吸入七氟醚后HR、MAP、SPO2差异均无显著意义（P〉0．05），泵注并丙酚后5min时HR降低（P〈0．01），MAP降低（P〈0．01），SPO2增高（P〈0．01）。吸入七氟醚后入睡时间13．92±4．26s，麻醉时间41．25±5．09min，苏醒时间4．23±1．58min，全组患儿均无缺氧发作、恶心呕吐。结论：七氟醚诱导复合异丙酚维持用于先心封堵麻醉，循环及呼吸平稳，不增加心脏的兴奋性，苏醒迅速，并发症少。Objective To evaluate the clinic effect of the application of Sevoflurane combined with propofol in children with congenital heart disease under-going cardiac catheterization Plugging. Methods two hundred and fifty-five ASA Ⅰ - Ⅱchildren with congenital heart disease undergoing cardiac catheteriza-tion Plugging were selected. The patients were premedicated with intravenous penehyclidine hydrochloride 0.01mg/kg,intravenous propofol 0. 01mg/kg 2 mi-nutes later and intravenous propofol 0.01mg/kg before intravenous contrast medium. H R, MAP, SPO2 were monitored and recorded before premedication, af-ter intravenous penehyclidine hydrochloride,after intravenous propofol, before intravenous contrast medium and after intravenous contrast medium. Time to fall asleep（s）,anesthesia time（min）and time to wake up（min）were recorded. To observe weather there were children nausea and vomiting after anesthesia. Results There are no significant differences in HR, MAP, SPO2 after intravenous penehyclidine hydrochloride, HR, MAP were decreased and SPO2 were in-creased after intravenous propofol. Time to fall asleep Was 13.92 ± 4. 26 （s）, anesthesia time was 21.25 ± 5.09 （min）and time to wake up was 4.23 ± 1.58 （min）. Follow-up after anesthesia indicated there were not children nausea and vomiting. Conclusion The application of penehyclidine hydrochloride com-bined with propofol in children with congenital heart disease undergoing cardiac catheterization Plugging can be satisfied to the demand of electrocardio-ga-ting technology. And it is safe and effective.

关 键 词：七氟醚 异丙酚 先心病 介入封堵 

分 类 号：R453[医药卫生—治疗学]