小儿先天性心脏病介入治疗中丙泊酚联合瑞芬太尼的临床观察

Clinical study of combined propofol and remifentanil anesthesia in the intervening therapy for congenital cardiovascular diseases in children

目的评价小儿先天性心脏病介入封堵术中联合应用丙泊酚和瑞芬太尼的临床效果。方法40例患儿,术前用阿托品0.02 mg/kg,入导管室后建立静脉通道,丙泊酚1.5 mg/kg,瑞芬太尼1μg/kg诱导,继以丙泊酚50μg.kg-1.min-1持续泵入。连续监测无创血压、心电图、脉搏血氧饱和度、心率、呼吸频率,观察呼吸幅度的变化及有无呼吸道梗阻;造影检查封堵的即刻效果。结果麻醉后心率、血压较麻醉前明显下降,脉搏血氧饱和度无明显下降,丙泊酚诱导迅速,作用平稳,术后苏醒快,苏醒期副作用少。结论丙泊酚复合瑞芬太尼诱导,持续泵入丙泊酚可安全地应用于小儿先心病心脏病的介入治疗中的麻醉。

Objective To evaluate the efficacy of combined propofol and remifentanil anesthesia in transcatheter closure for congenital cardiovascular diseases in children. Methods The 40 patients studied were first prepared with atropine 0.02 mg/kg, and then induced with propofol 1.5 mg/kg and remifentanil 1 μg/kg. The anesthesia was maintained by pumping propofol at a rate of 50 μg·kg^-1·min^-1. The indexes of HR, RR, MAP and SpO2 were monitored through the course of the closure procedure. Results Propofol behaved very well in inducing and maintaining anesthesia. Echo follow- up showed there was no residual shunt left 24 hours after the operation. Conclusion Combined propofol and remifentanil induction plus propofol maintenance is a safe anesthesia in the intervening therapy for congenital cardiovascular diseases in children.