快通道麻醉方法应用于婴儿先心病矫治术60例_医学论文.docVIP

快通道麻醉方法应用于婴儿先心病矫治术60例_医学论文 快通道麻醉方法应用于婴儿先心病矫治术60例_医学论文 作者：侯立朝　熊利泽　李萌萌　陈敏　白晓光 【关键词】 麻醉/方法 　　关键词: 麻醉/方法先心病手术拔管婴儿 　　摘 要:目的 观察快通道麻醉方法在婴儿先心病矫治手术中的应用. 方法 60例（年龄1mo～1a）拟接受先心病矫治手术的患儿，均采用小剂量芬太尼-异氟醚复合麻醉.观察围术期循环指标的变化及麻醉用药情况，患者术毕苏醒及拔管时间，术后转归等. 结果 所有患儿的平均动脉压、心率及中心静脉压在诱导后、手术开始前、劈胸骨后、转机前、停机后、手术结束时、入ICU后均没有显著改变.60例患儿中有16例术后拔管时间小于或等于3h，其ICU监护时间为（40±12）h另有30例患儿术后拔管时间在3～18h之间，其ICU监护时间（69±36）h明显延长（与小于或等于3h组比较，0.05）其余14例患儿术后拔管时间大于18h，其ICU监护时间（147±90）h进一步延长（与前两组比较，0.01）. 结论 小剂量芬太尼-异氟醚复合麻醉可以应用于婴儿先心病矫治手术，能在围术期维持循环稳定，为手术创造良好条件，有利于尽早拔管，并使缩短ICU监护时间成为可能. 　　Keywords:anesthesia-methodscongenital heart diseasesoperationsextubationinfant 　　Abstract:AIM To evaluate the feasibility of fast-track car-diac anesthesia applied to the patients undergoing scheduled corrective operation of congenital heart diseases（CHD）.METHODS 17patients scheduled for corrective operation　of CHD under combined anesthesia with a small-dose-fen-tanyl and isoflurane were studied.Cardiovascular parame-ters，usage of anesthetics，postoperative recovery and extu-bation time were observed.RESULTS Mean arterial blood pressure，heart rate and central venous pressure had no sig-nificant changes among postinduction，pre-operation，post-sternotomy，before extracorporal bypass，after extracorporal bypass，end of operation and after arriving ICU in all patients（Pgt0.05when compared with each other）.Of60patients，there were16ones with extubation time≤3hours，whose stay in ICU was40±12hoursand30ones with extubation timegt3hours but≤18hours，had longer ICU stay（69±36hours）than that in patients with extubation time≤3hours（0.05）the remaining14ones with extubation timegt18hours，had ICU stay of147±90hours，which was longer than that of the former two groups（0.01）.CONCLU┐SION Fast-track cardiac anesthesia with combined anesthe-sia of a small-dose-fentanyl and isoflurane could be applied to children（≤1years）undergoing CHD corrective operation，which could provide stable cardiovascular status during the period of anesthesia and operation，and facilita