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1名39岁男性右肾结石患者,拟在全麻下进行手术。静脉团注咪哒唑仑5mg、芬太尼0.2mg、维库溴铵8mg,丙泊酚40mg进行诱导行气管插管,持续泵入维库溴铵4mg/h、丙泊酚100mg/h、瑞芬太尼0.25mg/h维持麻醉。插管后患者出现支气管痉挛,气道压升高达40cmH2O,SpO2降至0.78,听诊双肺满布哮鸣音。先后给予异氟烷吸入、氨茶碱、地塞米松、氯胺酮静注,停止泵入瑞芬太尼,均无明显改善。停止泵入维库溴铵后,患者气道压逐渐下降,双肺哮鸣音减少。停止泵入丙泊酚,30min后,患者自主呼吸恢复,SpO升至0.99,双肺哮鸣音基本消失。
A 39-year-old right kidney stone patients, intended to be under general anesthesia surgery. Intravenous bolus midazolam 5mg, fentanyl 0.2mg, vecuronium 8mg, propofol 40mg induced tracheal intubation, continuous intravenous vecuronium 4mg / h, propofol 100mg / h, Remifentanil 0.25mg / h to maintain anesthesia. Patients after intubation bronchospasm, airway pressure up to 40cmH2O, SpO2 dropped to 0.78, auscultation of lungs covered with wheeze. Has given isoflurane inhalation, aminophylline, dexamethasone, ketamine intravenous injection stopped remifentanil, no significant improvement. After stopping the pump vecuronium, the patient’s airway pressure gradually decreased, lung wheeze reduction. Stop pumping into propofol, 30min, patients with spontaneous breathing recovery, SpO rose to 0.99, lung wheeze disappeared.