快通道麻醉在低龄小儿先天性心脏病手术中的应用  

Fast track anesthesia for congenital heart surgery of young children

作　　者：黎必万[1] 陈贤[1] 檀文好[1] 

机构地区：[1]广西钦州市第二人民医院麻醉科,535000

出　　处：《临床合理用药杂志》2014年第26期17-20,共4页Chinese Journal of Clinical Rational Drug Use

基　　金：广西卫生厅自筹经费课题项目(项目编号Z2013736)

摘　　要：目的评估快通道麻醉在低龄小儿心脏手术中的可行性。方法回顾2009年1月-2013年10月70例采用快通道麻醉先心病低龄(<5岁)患儿资料,分析总结其一般情况、麻醉方法、围术期血流动力学变化、拔管时间、拔管后0.5h血气分析,术后疼痛评分、转归。结果所有患儿术中血流动力学稳定,术后拔管时间均<6h,拔管后0.5h血气分析结果基本正常,术后疼痛评分<3.1,无1例需2次插管,无1例出现肺部并发症,术后无死亡病列,所有患儿均顺利康复出院。结论以小剂量舒芬太尼联合七氟醚行低龄小儿先心快通道麻醉能提供稳定的血流动力学,气管拔管时间短,镇痛充分,该麻醉模式安全有效,值得临床推广应用。Objective To evaluate the feasibility of fast track anesthesia for congenital heart surgery of young children. Methods From January 2009 to 0ctober 2013,70 young children with congenital heart disease undergoing cardiac surgery accepted the fast track anaesthesia induced with midazolam,sufentanil,etomidate,rocuronium. The general characteristics,anesthetic method,perioperative hemodynamic,postoperative extubation time,bood gas analysis 0. 5h after extubation,postoperative VAS and recovery were retrospectively analyzed. Results Perioperative haemodynamics of children was stable; postoperative extubation time was within 1- 6 hours; blood gas analysis outcomes was normal in 0. 5h after extubation; the VAS score was lower than 3. 1; no one needed reintubation; no children had pulmonary complications,all children successfully discharged.Conclusion Fast track anesthesia for congenital heart surgery of young children based on low-dose sufentanil combined with sevoflurane was feasible due to stable haemodynamics,with shorter extubation timen and effective analgesia,which is worthy of clinical application.

关 键 词：快通道麻醉 低龄小儿 先天手术 舒芬太尼 七氟烷 

分 类 号：R726.1[医药卫生—儿科]