Study on Sevoflurane Anesthesia for Pediatric Patients with Congenital Heart Disease_West China Medical Journal

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Department of Anesthesiology, Sichuan Provincial People’s Hospital, Chengdu Sichuan 610072, China;

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Keywords：

七氟醚; 全凭静脉麻醉; 先天性心脏病手术

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目的:观察、比较七氟醚吸入麻醉与全凭静脉麻醉在小儿先天性心脏病手术中的应用。方法: 40例择期行先天性心脏病房室缺矫治术患儿,随机分为七氟醚组和全凭静脉麻醉组(TIVA组),每组各20例。七氟醚组患儿以七氟醚吸入诱导,复合小剂量芬太尼、咪达唑仑、维库溴铵,麻醉维持为七氟醚吸入+芬太尼、维库溴铵;静脉组患儿肌注氯胺酮后,以芬太尼、咪达唑仑、维库溴铵诱导,维持使用丙泊酚持续泵入+芬太尼、维库溴铵。比较两组术中各时点血流动力学变化、手术麻醉时间与芬太尼、维库溴铵用量、术后呼吸支持时间、清醒时间、拔管时间,比较两组不良反应发生情况。结果: 两组患儿均维持比较稳定的血流动力学状态。七氟醚组芬太尼与维库溴铵用量明显低于TIVA组,呼吸支持时间、清醒时间、拔管时间明显低于TIVA组。七氟醚组2例术后发生躁动,3例发生恶心,稍高于TIVA组。结论: 七氟醚应用于小儿先心房室缺矫治术,可提供稳定的血流动力学状态,并降低芬太尼与肌松剂用量,实现术后早拔管、改善患者预后、降低医疗费用。

Citation： HUANG Jianxin,WANG Yu,LAN Zhixun,et al. Study on Sevoflurane Anesthesia for Pediatric Patients with Congenital Heart Disease. West China Medical Journal, 2009, 24(9): 2290-2292. doi: Copy

1.	MUTO R, MIYASAKA K, TAKATA M, et al. Initial experience of complete switchover to sevoflurane in 1550 children[J]. Paediatric Anaesthesia, 1993, 3 (1): 229.
2.	MuziM, Robinson BJ, Ebert TJ, et al. Induction of anesthesia andtracheal intubation with sevoflurane in adults[J]. Anesthesiology,1996, 85 (3): 5362543.
3.	MELLON RD, SIMONE AF, RAPPAPORT BA. Use of anesthetic agents in neonates and young children. Anesth Analg, 2007,104(3):509-20.
4.	俞卫锋. 麻醉与复苏新论[M]. 上海: 第二军医大学出版社, 2001: 81-95.
5.	WEI LX, DENG XM, LIU JH. Inductions and intubating conditions with sevoflurane and different doses of remifentanil without muscle relaxant in children[J]. Zhongguo Yi Xue Ke Xue Yuan Xue Bao, 2008,30(6):723-7.
6.	王庚. 安氟醚、七氟醚对维库溴铵肌松作用的影响[J]. 中华麻醉学杂志, 1997, 17 (6): 342-344.
7.	GAUGER PG, SHANKS A, MORRIS M. Propofol decreases early postoperative nausea and vomiting in patients undergoing thyroid and parathyroid operations[J]. World J Surg, 2008,32(7):1525-34.

1. MUTO R, MIYASAKA K, TAKATA M, et al. Initial experience of complete switchover to sevoflurane in 1550 children[J]. Paediatric Anaesthesia, 1993, 3 (1): 229.
2. MuziM, Robinson BJ, Ebert TJ, et al. Induction of anesthesia andtracheal intubation with sevoflurane in adults[J]. Anesthesiology,1996, 85 (3): 5362543.
3. MELLON RD, SIMONE AF, RAPPAPORT BA. Use of anesthetic agents in neonates and young children. Anesth Analg, 2007,104(3):509-20.
4. 俞卫锋. 麻醉与复苏新论[M]. 上海: 第二军医大学出版社, 2001: 81-95.
5. WEI LX, DENG XM, LIU JH. Inductions and intubating conditions with sevoflurane and different doses of remifentanil without muscle relaxant in children[J]. Zhongguo Yi Xue Ke Xue Yuan Xue Bao, 2008,30(6):723-7.
6. 王庚. 安氟醚、七氟醚对维库溴铵肌松作用的影响[J]. 中华麻醉学杂志, 1997, 17 (6): 342-344.
7. GAUGER PG, SHANKS A, MORRIS M. Propofol decreases early postoperative nausea and vomiting in patients undergoing thyroid and parathyroid operations[J]. World J Surg, 2008,32(7):1525-34.

West China Medical Journal

Study on Sevoflurane Anesthesia for Pediatric Patients with Congenital Heart Disease

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