小儿先心病导管麻醉体会

Anesthesia of children with congenital heart diseases in intervention clinic

目的介绍小儿先天性心脏病（先心病）患儿导管室内的麻醉体会。方法50例ASAI～Ⅲ级的先心病患儿静注硫酸阿托品0．02mg/kg、盐酸氯胺酮2mg/kg做基础麻醉，入室后肌注盐酸氯胺酮6mg/kg，静脉追加咪达唑仑0．1mg/kg，盐酸氯胺酮1mg/kg，并予面罩吸氧。术后入住麻醉苏醒室观察至患儿完全清醒。结果患儿血流动力学正常，能很好的耐受手术。诱导苏醒平顺，所有患儿无麻醉并发症发生。结论氯胺酮是安全、有效、经济的麻醉选择。麻醉处理关键在于熟悉病理生理，减少呼吸抑制的发生。

Objective To introduce our experience in intervention clinic anesthesia of children with congenital heart diseases. Methods Fifty ASA I -III children undergoing interventional therapy were selected. Children were injected with atropine sulfate （0.02 mg/kg） and ketamine （2 mg/kg） for anesthesia induction. When patients were in intervention clinic, ketamine （6-8 mg/kg） were given intromascularly for maintainence. During the procedure, ketamine （1-2 mg/kg） and midazolam （0.1 mg/kg） were given to deepen anesthesia, with oxygen inhalated by mask. Results Children were able to meet the surgical anesthesia, with the quick induction and wake up and no obvious side effects and complications. Conclusion Ketamine anesthesia, in children with congenital heart disease in the interventional treatment was salty. It is important for the anesthesiologists to be familiar with the pathophysiology of heart diseases, supply sufficiant oxygen, keep airway open, and unobstructed.