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禁食不一定减少胃液容量,麻醉诱导时仍有误吸的可能,因为禁食后不少病人的胃液仍可超过0.4ml·kg,pH 低于2.5,尤其是儿童这种情况甚至高达80%。作者选择门诊手术患儿88例,平均5.6岁(1～14岁),均无胃肠功能紊乱,ASA Ⅰ～Ⅱ级,随机分为4组。麻醉前2—3 h 均口服酚红(PSP)1 ml,不用其他术前药。A 组(21例)和 B 组(18例)给无渣不加糖的桔子汁5 ml·kg~(-1)(总量不超过150ml),A 组另加葡萄糖液0.2ml·kg~(-1)B 组另给呋喃硝胺(Ranitidine)2 mg·kg~(-1)加葡萄糖液0.2ml·kg~(-1)。C 组(19例)仅饮葡萄糖液0.2ml·kg~(-1);D 组(15例)仅用呋喃硝胺2mg·kg~(-1)加葡萄糖液0.2ml·kg~(-1)。麻醉后5 min 下胃管,抽尽胃内容,记录容量并测定 pH 和 PSP 含量。结果:各组吸出的平均胃液容量分别为:A 组(13例)0.34ml·kg(0—1.0ml·kg),B 组(18例)0.17ml·kg(0—0.7ml·kg),C 组(19例)0.25ml·kg(0—1.1ml·kg),D 组(15例)0.16ml·kg(0～0.6ml·kg)。平均 PH 值分别为 A 组(12例)1.83(0.9～3.6),B 组(15例)
Fasting does not necessarily reduce the volume of gastric juice, induction of anesthesia may still have the possibility of aspiration, because many patients after fasting gastric juice can still be more than 0.4ml · kg, pH less than 2.5, especially in children this situation even as high as 80% . The authors selected 88 patients with outpatient surgery, average 5.6 years (1 to 14 years), no gastrointestinal disorders, ASA Ⅰ ~ Ⅱ grade, were randomly divided into 4 groups. 2-3 h before anesthesia oral phenol red (PSP) 1 ml, without other preoperative drugs. In group A (21 cases) and group B (18 cases), 5 ml · kg -1 (no more than 150 ml) -1) In group B, 0.2 mg · kg -1 of Ranitidine and 0.2 ml · kg -1 of glucose solution were given separately. Group C (n = 19) only received 0.2ml · kg -1 of glucose solution; Group D (n = 15) received only 2mg · kg -1 of nitrofurazone plus 0.2ml · kg -1 ). 5 min after anesthesia gastric tube, pumping stomach contents, recording capacity and determination of pH and PSP content. Results: The average volume of gastric juice aspirated in each group were 0.34ml · kg (0-1.0ml · kg) in group A, 0.17ml · kg (0-0.7ml · kg) in group B (18 cases) Group C (n = 19) 0.25ml · kg (0-1.1ml · kg), Group D (n = 15) 0.16ml · kg (0 ~ 0.6ml · kg). The mean PH values were 1.83 (0.9 ~ 3.6) in group A (n = 12), 15 (n =