摘要
目的探讨合并有食管气管瘘的新生儿食道闭锁修补手术麻醉中的呼吸管理。方法收集我院自2008年4月以来6例新生儿食道闭锁修补手术的麻醉记录，回顾其麻醉诱导和维持期的呼吸管理方法，分析麻醉期间不同时点的重要生命体征如心率、呼吸频率、PETCO2，SpO2和麻醉相关并发症。结果6例患儿均采用了以七氟醚为主复合适当静脉麻醉药物的麻醉方法。在结扎气管食管瘘口前均保留了自主呼吸，所有患儿均能维持足够的通气，无一例患儿发生严重呼吸抑制和返流误吸。在麻醉诱导期，心率、呼吸频率、PETCO2和SpO2均平稳；开胸到结扎瘘口期间，心率、呼吸频率和PETCO2轻度升高；SpO2在轻度辅助通气下保持较好水平。结论在新生儿食道闭锁修补手术从麻醉诱导到结扎气管食管瘘，采用七氟醚为主复合适当静脉麻醉药物，可以很好地保留自主呼吸，降低返流误吸。
Objective To study respiratory management during anesthesia for esophageal atresia repair in neonates. Methods Anesthesia records of six neonates who had tracheoesophageal astria repair in West China Hospital since april 2008 were reviewed. The respiratory management strategies for anesthesia induction and maintenance were collected. The vital signs including heart rate, breath rate, PETCO2 and SpO2 at various time points during anesthesia were analyzed and anesthesia related complications were reviewed. Results Sevoflurane-based anesthesia was used for induction and maintenance for all cases. Spontaneous breath was maintained until the ligation of fistula. All neonates were adequately ventilated, no severity respiratory depression and aspiration occurred in any cases. During the anesthesia induction, the heart rate, breathing rate, PETCO2 and SpO2 were stable. From chest opening to tracheoesophageal fistula ligation, the heart rate, PET-CO2 and breathing rate were slightly increased while SpO2 was well maintained with gentle assisted ventilation. Conclusion Spontaneous breath can be easily maintained by using sevoflurane-based anesthesia up to the ligation of tracheoesophageal fistula for neonates undergoing tracheoesophageal astria repair, which may maintain an adequate ventilation while reducing the risk of aspiration.
出处
《国际麻醉学与复苏杂志》
CAS
2009年第5期411-413,435,共4页
International Journal of Anesthesiology and Resuscitation
关键词
食道闭锁
麻醉
七氟醚
呼吸管理
Esophageal atresia
Anesthesia
Sevoflurance
Respiratory management
