七氟烷联合丙泊酚用于小儿微创心脏手术的麻醉效果观察

The observation of sevoflurane compound with propofol for anaesthesia in children minimally invasive heart surgery

目的:观察七氟烷联合丙泊酚用于小儿微创心脏手术麻醉诱导和维持的可行性。方法:选择择期行体外循环下心内直视手术小儿56例。应用4%～6%七氟烷+O2吸入诱导,意识消失后顺序静脉注射咪达唑仑0.06mg/kg、芬太尼5μg/kg、维库溴铵0.15mg/kg麻醉诱导气管插管,术中麻醉维持用1.0%～2.5%七氟烷吸入+丙泊酚+芬太尼+维库溴铵。结果:4%～6%七氟烷吸入诱导患儿意识消失后收缩压、舒张压、平均动脉压和心率的变化与诱导前差异均无统计学意义(P>0.05)。CPB后1minMAP与HR和CPB后20minMAP均明显低于CPB前(P<0.01),而CPB停机时,MAP和HR与CPB前差异均无统计学意义(P>0.05),术后均无麻醉相关并发症发生。结论:小儿微创心脏手术应用七氟烷联合丙泊酚麻醉诱导迅速、平稳,术中麻醉深度可控性好,可满足小儿微创外科手术的需求。

Objective：To observe the feasibility of sevoflurane compound with propofol for anaesthesia used in children minimally invasive heart surgery.Methods：Fifty-six cases of children were undertaken intracardiac procedures with cardiopulmonary bypass.These cases were inducted with 4%-6% sevoflurane and O2 inhalation,5 μg/kg of fentanyl and 0.06 mg/kg of midazolam through intravenous injection,vecuronium at 0.15 mg/kg were used in sequences for anaesthesia.Adopted 1.0%-2.5% sevoflurane inhalation compound with fentanyl and vecuronium to keep a good anaesthesia condition.Results：Fifty-six cases were kept a good anaesthesia effect which the process is steady,and blood pressure and heart rate were maintained steadily during operation（P〉0.05）.Mean arterial pressure（MAP）,heart rate（HR）in post-CPB 1 minute,20 minutes were significantly lower than in pre-CPB（P〈0.01）.But MAP and HR in CPB shutdown compared with in pre-CPB no significant difference（P〉0.05）.The anaesthetizes relevant complications were not appeared after operation.Conclusions：Sevoflurane compound with propofol for anaesthesia can meet the demand in children minimally invasive heart surgery which is steadily and rapidly,and the anaesthesia profundity can be well controlled.