小儿吸入麻醉诱导临床应用-左云霞.pptx

小儿吸入麻醉临床应用;小儿围手术期死亡率;小儿围手术期死亡率;The decreased number of arrests associated with the inhaled anesthetics probably relates to the declining use of halothane in pediatric anesthesia practice in favor of newer anesthetics, particularly sevoflurane. Sevoflurane has been reported to have less potentialfor producing bradycardia and myocardial depression in infants and children than does halothane. Halothane also causes more hypotensive episodes than sevoflurane in children with congenital heart disease . ;The decline in 1998–2004 in the proportion of ASA physical status 1–2 children and infants less than 1-year-of-age may also be ascribed to the declining use of halothane, since halothane-induced cardiovascular depression tended to occur in previously healthy children under 1-year-of-age.;小儿麻醉诱导特点;小儿吸入麻醉诱导;小儿吸入麻醉诱导临床操作规范;诱导前准备;患儿病情评估;患儿安全核查;诱导前准备; 小婴儿保???床准备;小儿吸入麻醉诱导临床操作规范;诱导实施;诱导准备;麻醉前用药推荐： 麻醉诱导前10-20分钟口服含咪达唑仑0.25-0.5mg/kg的糖浆 不合作的大龄儿童可加入3mg/kg 氯胺酮 抗胆碱能药物不作为常规使用;吸入麻醉诱导药物的选择： 一般采用麻醉效能强、血气分配系数低、无刺激性气味的七氟烷 地氟烷尽管血气分配系数低，但因刺激性强不适合吸入麻醉诱导 异氟烷血气分配系数高和刺激性强不适合做吸入诱导;诱导实施;呼吸回路预充方法;潮气量法诱导：适于所有患儿;如何固定患儿的头部;肺活量法诱导：适合于合作的患儿;浓度递增法诱导：适于合作的小儿及危重患儿;小儿吸入麻醉诱导临床操作规范;诱导注意事项;预先吸入笑气;诱导注意事项（续）; 总结