Ebstein畸形矫治术的合理麻醉处理

Anesthetic reasonable management for correction of Ebstein's deformity

目的总结Ebstein畸形矫治术的麻醉处理经验。方法Ebstein畸形矫治术的麻醉处理19例。成人患者术前口服安定10mg,肌注东莨菪碱0.3mg,吗啡10mg;而12岁以下小孩诱导前肌注氯胺酮6～7mg/kg、东莨菪碱0.01mg/kg。全麻诱导静脉注射咪唑安定0.01-0.03mg/kg,依托咪酯0.1～0.3mg/kg,芬太尼5-10μg/kg,哌库溴铵0.1mg/kg麻醉诱导,吸入1MAC异氟醚。持续静脉输注异丙酚0.8～2μg/ml;间断给予芬太尼5～10μg/kg,哌库溴铵0.05mg/kg。结果麻醉平稳,所有患者术后症状明显改善,围术期无一例死亡。结论采用复合麻醉药物的处理,对Ebstein畸形矫治术具有良好的麻醉效果。

Objective To summarize the experience in anesthetic management for correction of Ebstein＇s deformity. Methods Anesthesia was done for 19 patients undergoing correction of Ebstein＇ s deformity. The adults patients were premedicated with oral diazepam 10mg,and intramuscular morphine 10mg and hyosine 0.3 mg. The children patients were premedicated with intramuscular ketamine 6-7 mg/kg and hyosine 0.01 mg/kg. General anesthesia was induced with midazolam 0.01-0.03 mg/kg, etomidate 0.1-0.3 mg/kg,fentanyl 5-10μg/kg,pipecuronium 0.1 mg/kg,and maintained with isoflurane inhalation and propofol infusion. And intermittent iv. fentanyl and pipecuronium. Results Anesthetic course was smooth. The symptom in all cases was improved significantly after operation. No patients died during operative period. Conclusion Suitable compound anesthesia for correction of Ebstein＇s deformity has an excellent anesthetic effect.