巴马小型猪肝大部切除术的麻醉管理.docVIP

巴马小型猪肝大部切除术的麻醉管理 张昌盛1，张爱群2，许寅喆2，王显望1，曹江北1，董家鸿2，米卫东1 （1.解放军总医院麻醉手术中心，北京100853；2.解放军总医院全军肝胆外科研究所，北京100853） 【摘要】 目的 探讨巴马猪肝大部切除术的麻醉管理策略。方法 健康雄性巴马猪30头，采用肌肉注射氯胺酮12mg/kg镇静后，戊巴比妥钠24mg/kg诱导气管内插管，行肝左三叶切除术，术中异氟醚维持麻醉。术中依据循环波动适时调整麻醉用药，依据脉氧饱和度和呼气末二氧化碳分压调整机械通气参数。结果 实验所用30例巴马猪中，26例安全度过围手术期，手术过程中平均动脉压（MAP）变化幅度均20%，颈静脉压（JVP）维持在3～6mmH2O，脉氧饱和度（SpO2）均保持在95%以上，3例发生不良事件。结论 小型猪肝大部切除术的麻醉要求用药适当、监测完善、液体管理良好、生理指标异常的及时妥善处理，尤其重视在肝大部切除前后维持循环稳定，妥善保护剩余肝脏功能。 【关键词】麻醉管理；肝大部切除术；巴马猪 【中图分类号】R614.27 【文献标识码】 【文章编号】 Anesthesia management of the Bama minipigs for major hepatectomy ZHANG Chang-sheng1, ZHANG Ai-qun2, XU Yin-zhe2, WANG Xian-wang1, CAO Jiang-bei1, DONG Jia-hong2, MI Wei-dong1 (1. Anesthesia and Operation Center, Chinese PLA General Hospital, Beijing 100853, China；2. Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Beijing 100853, China) [Abstract] Objective To explore the management of anesthesia of the Bama minipigs for major hepatectomy. Methods 30 healthy male Bama minipigs were chosen for hepatic trisegmentectomy. Ketamine 12mg/kg were given by intramuscular for basic anesthesia before anesthesia induction and intubation using pentobarbital sodium 24mg/kg. Isoflurane inhalation anesthesia was used for anesthesia maintenance. Anesthetics dosages were adjusted according to the change of hemodynamics. And the mechanical ventilation parameters were regulated in accordance with SPO2 and PETCO2. Results 26 of the 30 Bama minipigs get through the perioperative period successfully. The range of the mean arterial pressure (MAP) was less than 20% and the jugular venous pressure (JVP) was kept at 3~6mmH2O during the operation. And the SPO2 was kept above 95% throughout the operation. Adverse event was occurred on 3 pigs. Conclusion The management of anesthesia of the Bama minipigs for major hepatectomy needs appropriate drug and fluid management, complete monitoring, and properly handling the abnormity of physical signs. The hemodynamics stability during the hepatectomy and t