新生儿七氟醚诱导无肌松药气管插管的临床观察

Clinical Observation of Sevoflurane-induced Tracheal Intubation without Muscle Relaxant in Neonate

目的:观察新生儿在不使用肌松药的情况下,单纯以七氟醚诱导后的插管条件及血流动力学变化。方法:纳入急诊行剖腹探查术的新生儿40例,美国麻醉医师协会(ASA)Ⅱ～Ⅲ级,体重1.7～3.0kg;先由面罩给予8%七氟醚诱导,待患儿睫毛反射消失后,维持吸入呼气末浓度为4%的七氟醚3min,即行气管插管。记录诱导前、插管前1min、插管时、插管后3min的心率(HR)、血压(BP)、脉搏血氧饱和度(SpO2)及插管条件评分。插管条件评分由操作者完成。结果:插管成功率100%;插管前1minHR、BP较诱导前下降(P<0.05)。结论:新生儿在不使用肌松药的情况下,单纯以七氟醚诱导后的插管条件良好,血流动力学平稳。

OBJECTIVE：To observe intubation conditions and hemodynamic changes after anesthesia induction only with sevoflurane in neonate without muscle relaxant.METHODS：40 ASA Ⅱor Ⅲ neonate for emergency exploratory laparotomy were enrolled into this study.The body weight was from 1.7 kg to 3.0 kg.Anesthesia was induced with sevoflurane 8% in oxygen.After loss of eyelash reflex,end-tidal sevoflurane concentration 4% was maintained for 3 minutes.Then,the trachea was incubated.Heart rate（HR）,blood pressure（BP）,pulse oxygen saturation（SpO2）,and the score of intubation condition were recorded at before anesthesic induction,1 min before intubation,intubation,3 min after intubation.The condition of intubation was graded by runner.RESULTS：The achievement ratio of intubation was 100%.HR and BP 1 min before intubation were lower than before induction（P0.05）.CONCLUSION：The intubation condition is good for neonate after sevoflurane induction without muscle relaxant,and hemodynamic is stable.