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目的:探讨快通道麻醉在高原小儿先天性心脏病手术中的应用价值。方法:选择528例先天性心脏病小儿,ASA(I～Ⅲ)级择期手术,麻醉诱导。静脉注射咪唑安定、枸橼酸芬太尼、维库溴铵后气管插管控制呼吸。麻醉维持:微量泵持续注入枸橼酸芬太尼20μg/(kg.h),同时根据麻醉的深浅适当调整异氟醚吸入浓度。结果:本组528例患者,521例均在术后(1～6)h内清醒气管拔管,5例术后出现严重的低心排4小时内死亡,2例因胸导管引流>50mL/30min带管二次手术术后3h拔管。所有病人无二次再插管。结论:快通道麻醉在高原小儿先天性心脏病手术中完全可以施用,具有临床应用价值。
Objective: To explore the value of fast-track anesthesia in the operation of children with congenital heart disease in the plateau. Methods: 528 children with congenital heart disease, ASA (Ⅰ ~ Ⅲ) stage elective surgery and anesthesia induction were selected. Intravenous midazolam, fentanyl citrate, vecuronium tracheal intubation control breathing. Anesthesia maintenance: micro-pump continuous infusion of fentanyl citrate 20μg / (kg.h), according to the depth of anesthesia appropriate adjustment of inhalation concentration of isoflurane. Results: In 528 patients, 521 patients were extubated after extubation (1 ~ 6 h), 5 patients died of serious low cardiac output within 4 hours after operation, and 2 patients died of thoracic duct drainage> 50 mL / 30min tube surgery 3h after extubation. All patients without second re-intubation. Conclusion: Fast-track anesthesia can be completely applied in the operation of children with congenital heart disease in the plateau, which has clinical value.