氨茶碱对先天性心脏病矫治术患儿超快通道麻醉气管拔管效果的影响  

Effect of aminophylline on efficacy of extubation under ultra-fast track anesthesia in pediatric patients with congenital heart disease undergoing surgical correction of anomaly

作　　者：张朝宾 贾爰 王嵘 孙莉 晏馥霞 Zhang Chaobin;Jia Yuan;Wang Rong;Sun Li;Yan Fuxia(Department of Ancsthesiology,National Cancer Center/Cancer Hospital,China Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China;Department of Anesthe-siology,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100037,China)

机构地区：[1]国家癌症中心、中国医学科学院、北京协和医学院、肿瘤医院麻醉科,100021 [2]中国医学科学院、北京协和医学院、国家心血管病中心、中国医学科学院阜外医院麻醉科,100037

出　　处：《中华麻醉学杂志》2018年第8期969-972,共4页Chinese Journal of Anesthesiology

摘　　要：目的 评价氨茶碱对先天性心脏病矫治术患儿超快通道麻醉气管拔管效果的影响.方法 择期先天性心脏病矫治术患儿90例,ASA分级Ⅰ或Ⅱ级,年龄<6岁.采用随机数字表法分为3组(n=30):外科手术结束后,Ⅰ组给予生理盐水,Ⅱ组给予1 mg∕kg氨茶碱,Ⅲ组给予2 mg∕kg氨茶碱.记录患儿手术室气管拔管情况和气管拔管时RR,分别于术毕、给药后9和15 min时记录MAP、HR和BIS值.结果 与Ⅰ组比较,Ⅱ组和Ⅲ组手术室气管拔管成功率、给药后9 min时BIS值和气管拔管时RR升高(P<0.05);Ⅱ组和Ⅲ组上述指标差异无统计学意义(P>0.05).结论 氨茶碱可提高心脏病矫治术患儿超快通道麻醉气管拔管的效果,推荐剂量1 mg/kg.Objective To evaluate the effect of aminophylline on the efficacy of extubation under ultra-fast track anesthesia ( UFTA) in pediatric patients with congenital heart disease ( CHD) undergoing surgical correction of anomaly. Methods Ninety American Society of Anesthesiologists physical status Ⅰor Ⅱ pediatric patients, aged<6 yr, undergoing surgical correction of anomaly, were randomized into 3 groups ( n=30 each) using a random number table method: group Ⅰ, group Ⅱ and group Ⅲ. After the end of surgery, normal saline was given in groupⅠ, 1 mg∕kg aminophylline was given in groupⅡ, and 2 mg∕kg aminophylline was given in groupⅢ. The condition of extubation in the operating room and respirato-ry rate at extubation were recorded. Mean arterial pressure, heart rate and bispectral index value were re-corded at the end of surgery, and at 9 and 15 min after administration. Results Compared with groupⅠ, the rate of successful extubation in the operating room, BIS value at 9 min after administration and respira-tory rate at extubation were significantly increased inⅡand Ⅲ groups ( P<0. 05) . There was no significant difference in the parameters mentioned above between group Ⅱand group Ⅲ ( P>0. 05 ) . Conclusion Aminophylline can increase the efficacy of extubation under UFTA in pediatric patients with CHD undergoing surgical correction of anomaly, and 1 mg is the recommended dose.

关 键 词：氨茶碱 心脏缺损 先天性 麻醉 气管 

分 类 号：R726.1[医药卫生—儿科]