摘要
目的对比研究气管异物取出术的两种麻醉方法,以找出更快速、安全、有效的麻醉方法。方法选取就诊于本院行气管异物取出术的患者,将其随机分为两组,保留自主呼吸组A组,复合肌松药麻醉机控制通气组B组。A组:入室后常规监测,给予面罩纯氧吸入。依次静脉注射咪达唑仑、依托咪酯、瑞芬太尼,并置入喉镜喷入利多卡因对气道黏膜进行表面麻醉,维持麻醉用瑞芬太尼、丙泊酚。手术时通过气管镜侧孔持续供氧。B组在A组麻醉诱导的基础上静脉注射琥珀胆碱。手术开始后麻醉机连接气管镜侧孔,以压力通气模式控制呼吸。术毕,面罩辅助呼吸,待患儿自主呼吸正常,完全清醒后送回病房。记录手术时间、钳夹异物次数、血氧饱和度低需要中断手术供氧次数,面罩吸氧时和钳取异物时的血气分析指标。结果 B组的手术时间短于A组,钳夹次数、手术中断次数少于A组(P<0.05);T2时,B组氧合较A组好(P<0.05),术中B组SpO2较A组高,心率和血压较A组低(P<0.05)。结论复合肌松药静脉全身麻醉在麻醉机控制下,通过侧孔控制通气可以保证患者术中的氧供,比传统的保留自主呼吸的麻醉方法有很多方面的优势。
Objective To compare and research two different methods of anesthesia in the removal operation of tracheal foreign body to find a swift,safe and effective method of anesthesia. Methods Patients treated in our hospital with the removal operation of tracheal foreign body were selected and randomly divided into the two groups,the group A was re- tained spontaneous breathing,the group B was compound muscle relaxant anesthesia machine controling ventilation group.The group A was monitored regularly after admitting room and given pure oxygen inhalation through mask,general anesthesia was induced with midazolam,etomidate,remifentanil.Laryngoscope was inserted and lidocaine was spurted to do surface anesthesia in the airway mucosal.Anesthesia was maintained with remifentanil and propofol.Oxygen was keeping inhalation through the bronchoscope side opening during operation.Based on the induction of anesthesia of the group A,succinylcholine was intravenous injected.After the start of operation,anesthesia machine connected to the bron- choscope side opening,and the children breathing was controlled with pressure ventilation mode.At the end of the opera- tion,face mask assisting respiration,when patients breathed normally,fully awaked and they were sent to the ward.The operating time,the number of times for foreign body clamped,the times of interrupting the operation for lower oxygen saturation,blood gas analysis index of during mask oxygen and removal of foreign body were recorded. Results The op- erative time in the group B was shorter than that in the group A,clamping times and the frequency of interrupting surgery in the group B wasfewer than that in the group A（P〈0.05）;oxygenation of the group B was better than that of the group A （P〈0.05）;SpO 2 of the group B was higher than that of the group A, heart rate and blood pressure was lower than that of the group A （P〈0.05）. Conclusion Intravenous general anesthesia compositing muscle relaxants under con- trolled by anesthesia machine through lateral apertur
出处
《中国当代医药》
2014年第11期95-97,共3页
China Modern Medicine
关键词
小儿气管异物
两种麻醉方法
比较
Pediatric tracheal foreign body
Two anesthetic methods
comparison
