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目的观察小儿5%七氟烷复合0.3μg/kg瑞芬太尼诱导下经纤维支气管镜气管插管的临床效果。方法选择全麻手术患者36例,年龄6～10岁、ASA分级Ⅰ～Ⅱ级,行静吸复合麻醉诱导的眼科手术的小儿,入室后吸入5%七氟烷,2min后在1 min内静脉注射瑞芬太尼0.3μg/kg,在呼吸末端七氟烷浓度为3.2%～3.4%时,经纤维支气管镜气管插管;插管完毕后给予维库溴铵0.1 mg/kg、瑞芬太尼2μg/kg加深麻醉。观察诱导插管过程中插管满意率、患儿呼吸情况及插管对循环功能的影响等。结果插管成功率为94.4%,插管满意率为80.6%。麻醉诱导后与插管时、插管后比较对循环功能的影响较小,患儿自主呼吸保持良好。结论吸入5%七氟烷联合0.3μg/kg瑞芬太尼诱导过程平稳,在保证自主通气的前提下能顺利完成经纤维支气管镜气管插管。
Objective To observe the clinical effect of tracheal intubation with bronchoscope induced by 5% sevoflurane and 0.3 μg / kg remifentanil in children. Methods Thirty-six patients undergoing general anesthesia were enrolled in this study. Thirty-six children aged from 6 to 10 years with ASA grading Ⅰ to Ⅱ underwent anesthesia-induced ophthalmic surgery. Five percent of sevoflurane was inhaled after admission. Remifentanil 0.3μg / kg, respiratory end sevoflurane concentration of 3.2% to 3.4%, endotracheal intubation bronchoscopy; after administration of vecuronium 0.1 mg / kg, remifentan Niger 2μg / kg deepening anesthesia. To observe the intubation satisfaction rate during intubation, respiratory status of children and intubation on the circulatory function. Results The success rate of intubation was 94.4% and satisfaction rate of intubation was 80.6%. After induction of anesthesia and intubation, intubation after the comparison of the smaller impact on circulatory function, spontaneous breathing in children maintained well. Conclusions The induction of 5% sevoflurane combined with 0.3 μg / kg remifentanil is smooth and the endobronchial intubation via fiberoptic bronchoscopy can be successfully completed under the premise of spontaneous ventilation.