小儿麻醉与小儿术中输液（Infusion in pediatric anesthesia and pediatric surgery）.docVIP

小儿麻醉与小儿术中输液（Infusion in pediatric anesthesia and pediatric surgery） Infusion in pediatric anesthesia and pediatric surgery I. anatomical and physiological features of children: 1. Respiratory system: The babys head and tongue are relatively large, the neck is short, and the throat is high The upper respiratory tract is the most narrow cricoid cartilage, so infants do not usually need endotracheal tubes with a cuff After 6 years of age, the narrowest part of the childs glottis needs a endotracheal tube with a cuff. 2. Circulatory system: the absolute value of blood volume in children is very small, the heart is sensitive to capacity load, and the tolerance to blood volume change is poor. Pediatric cardiac output is rate dependent, below 1 years old childrens heart rate less than 100 BPM to correct. 3, liver and kidney function: neonatal liver enzyme system hypoplasia, poor drug binding, slow metabolism, sensitive to anesthetics, and long acting time. Neonatal glomerular and renal tubular dysfunction, low absorption of sodium, such as infusion without sodium ions can produce hyponatremia. Liver and kidney function in children is close to adult at age 1. Two. Preparation before anesthesia 1, preoperative fasting, drinking time Infants under 6 months of fasting for 4 hours, 2 hours of water, more than 6 months of fasting children 6 hours, 2~3 ban water 2. Premedication Commonly used drugs: midazolam 0.2 mg / kg to 0.3, 6 mg / kg orally; ketamine oral or nasal; atropine 0.1 mg / kg or +0.01 mg / mg +0.01 0.3 mg of penehyclidinehydrochloride kg intramuscular or intravenous injection. Medication principle: less than 8 months of infants do not have sedative drugs, fever children without atropine. 3. Anesthesia preparation for children with complications 1: on the upper respiratory tract infection in children, the stress of the upper respiratory tract mucous membrane increased, prone to hypoxemia and postoperative pneumonia, laryngospasm, bronchospasm, surgery, should be avo