重症二尖瓣置换术麻醉处理技巧会议论文.pdfVIP

2005 北京国际华人心血管麻醉论坛资料汇编 - 1 - 重症二尖瓣置换术麻醉处理技巧 李锡初1 曾庆诗2 孙来保3 广州市番禺区人民医院 麻醉科511400 广东省心血管病研究所 麻醉科 广东 广 州510080 3 中山医科大学附属第一医院 麻醉科 广东 广州510080 摘要 目的 分析我院80 例重症二尖瓣置换围术期麻醉处理 方法 以咪唑安定0.2mg kg 芬太尼10 g kg 万可松0.1mg kg 和利多卡因2mg kg 诱导麻醉 术中追加芬 太尼 咪唑安定和吸入异氟醚维持麻醉 术中心肌保护应用低温高钾自体氧合血灌注 体外 循环结束后给予适量的正性肌力药和血管扩张剂支持循环 术后以机械通气支持呼吸 结果 本组麻醉诱导和术中血流动力学较为稳定 术后呼吸支持时间为36.5 13.6 小时 术后仅 死亡 1 例 结论 术前充分镇静 平稳的麻醉诱导 良好的心肌保护以及术后适当循环和 呼吸支持 是重症二尖瓣置换围术期麻醉处理中非常重要的措施 关键词 重症二尖瓣置换术 麻醉; 管理 Perioperitive anesthesia management to patient with severe mitral valve disease by mitral valve replacement. Li Xi-chu1 Zeng Qing-shi2 Sun Laibao3 1 Department of Anesthesiology Panyu Hospital,Guangzhou 5 11400 2 Department of Anesthesiology Guangdong Research Institute of Cardiovascular Disease Guangzhou 510080 3 Department of Anesthesiology First Affiliated Hospital Sun Yat-senn University of Medical Sciences Guangzhou 510080 china ABSTRACTS Objective To analysis the perioperitive anesthesia management for mitral valve replacement in 80 patients with severe mitral valve disease . Methods Midazolam 0.2mg/kg and fentanyl 10 g/kg vecuronium 0.1 mg/kg lidocaine 2mg/kg were used for induction of anesthesia . anesthesia was maintained by Midazolam fentanyl and vecuronium intravenously and isoflurane of inhalation Positive inotropic drugs and vasodilator were used for support the circulation post-bypass. ventilation therapy were used for support the respiration postoperatively. Results There was no difference significantly in hemodynamics during operation and preanesthesia(P 0.05) ,postoperative supported respiration f