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目的 观察快通道麻醉方法在婴儿先心病矫治手术中的应用 .方法 6 0例 (年龄 1mo～ 1a)拟接受先心病矫治手术的患儿 ,均采用小剂量芬太尼 -异氟醚复合麻醉 .观察围术期循环指标的变化及麻醉用药情况 ,患者术毕苏醒及拔管时间 ,术后转归等 .结果 所有患儿的平均动脉压、心率及中心静脉压在诱导后、手术开始前、劈胸骨后、转机前、停机后、手术结束时、入 ICU后均没有显著改变 .6 0例患儿中有 16例术后拔管时间小于或等于 3h,其 ICU监护时间为 (4 0±12 ) h;另有 30例患儿术后拔管时间在 3～ 18h之间 ,其 ICU监护时间 (6 9± 36 ) h明显延长 (与小于或等于 3h组比较 ,P<0 .0 5 ) ;其余 14例患儿术后拔管时间大于 18h,其 ICU监护时间 (147± 90 ) h进一步延长 (与前两组比较 ,P<0 .0 1) .结论 小剂量芬太尼 -异氟醚复合麻醉可以应用于婴儿先心病矫治手术 ,能在围术期维持循环稳定 ,为手术创造良好条件 ,有利于尽早拔管 ,并使缩短 ICU监护时间成为可能
Objective To observe the application of fast-track anesthesia in the treatment of infants with congenital heart disease.METHODS Sixty patients (aged 1mo ~ 1a) were enrolled in this study. All children undergoing surgery for congenital heart disease were treated with low-dose fentanyl-isoflurane combined anesthesia. The changes of perioperative circulatory indexes and anesthetic drug use were observed, and the patients recovered after operation, the time of extubation, the prognosis after operation, etc. Results All patients had mean arterial pressure, heart rate and central venous pressure after induction, before surgery, After splitting the sternum, before turning off, after stopping, at the end of surgery, there was no significant change after ICU admission.Of sixty cases of children, 16 cases had extubation time less than or equal to 3 hours and ICU monitoring time was (40 ± 12) h. Another 30 patients had extubation time between 3 and 18 hours, and the ICU monitoring time (69 ± 36) h was significantly prolonged (P <0.05 compared with less than or equal to 3 hours) ). The remaining 14 patients had extubation time greater than 18h, and the ICU monitoring time (147 ± 90h) was further prolonged (P <0.01 compared with the previous two groups. Fluoroether anesthesia can be used in infants with congenital heart disease surgery, to maintain the perioperative follow-up Stability, create favorable conditions for the operation, is conducive to early extubation, and make it possible to shorten the time of ICU care