安置永久起搏器患者心脏手术中的麻醉管理  

Anesthetic Management of Placement Perpetual Pacemaker in Patients Undergoing Cardiac Surgery

作　　者：李正凯[1] 

机构地区：[1]郑州大学附属郑州中心医院麻醉科,河南郑州450007

出　　处：《中国继续医学教育》2016年第10期49-50,共2页China Continuing Medical Education

摘　　要：目的探讨安置永久起搏器患者心脏手术中的麻醉管理方法。方法选取我院2013年5月~2015年8月收治的永久起搏器且行心脏手术的患者。术前给予吗啡、东茛菪碱。冠心病患者术前2 h,给予口服地西泮片等药物,气管插管控制呼吸。术中监测患者收缩压（SBP）、舒张压（DBP）、平均动脉压（MAP）、心率（HR）、心电图（ECG）等情况,使用单级电刀、电凝,控制输出功率为25~35 J,短脉冲放电,关闭胸腔前均给予预防性放置临时起搏器。结果手术均顺利进行,6例患者控制起搏模式,其他患者起搏模式未见改变。结论掌握麻醉对永久起搏器的影响作用可降低危险性,提高手术的安全性。Objective Discussion of permanent pacemaker implantation of cardiac surgery patients anesthesia management.Methods Selected permanent pacemaker cardiac surgery from May 2013 to August 2015 in our hospital.Preoperative morphine,scopolamine.Preoperative coronary heart disease 2 hours,given oral diazepam tablets and other drugs,intubated control breathing.Intraoperative monitoring of patients with systolic blood pressure（SBP）,diastolic blood pressure（DBP）,mean arterial pressure（MAP）,heart rate（HR）,electrocardiogram（ECG）,et al,using a singlestage electric knife,coagulation,try to control the output power of 25 to 35 J,short pulse discharge,all patients were treated with closed chest preventive placement of a temporary pacemaker.Results All patients were operated successfully performed in 6 patients control pacing mode.No changes were seen in patients with other pacing mode.Conclusion Grasp the influence of anesthesia on a permanent pacemaker to reduce risk and improve the safety of surgery.

关 键 词：永久起搏器 心脏手术 麻醉管理 

分 类 号：R614[医药卫生—麻醉学]