危重新生儿手术的麻醉处理

Anesthetic Intervention of the Neonates at High Risk during Surgical Operation

目的 :提高危重新生儿手术麻醉的安全性。方法 :术前用山莨菪碱 0 .0 6mg ,诱导用氯胺酮 2mg·kg-1、维库溴铵 0 .0 8～ 0 .1mg·kg-1静脉注射后行气管插管 ;或咽喉部 1%盐酸利多卡因溶液表面麻醉 ,羟丁酸钠 5 0～ 80mg·kg-1,氯胺酮 2mg·kg-1注射后插管 ,均接麻醉机 ,静脉复合麻醉 ,监测SpO2 浓度 ,术毕用多沙普仑 1～ 2mg·kg-1催醒。结果 :10 0例患儿全部麻醉获得成功 ,无 1例死亡。结论 :做好必要的术前准备 ,加强术中监测 ,合理用药 ,选择适当的麻醉方法 ,可提高危重新生儿手术麻醉的安全性。

Objective: To improve the safety of anesthesia of the neonates at high risk during surgical operation. Methods:Before the operation, Anisodamine, Ketamine and Vecuronium bromide were injected intravenously with dosage of 0.06mg, 2mg·kg -1 and 0.08-0.1mg·kg -1, respectively. Tracheal cannula or topical anesthesia using 1% of lidocaine hydrochloride was performed. The tracheal cannulation was performed after administration of sodium hydroxybutyrate and Ketamine by injection with dosages of 50-80 mg·kg -1 and 2mg·kg -1 body weight. Anesthesia apparatus and combinative anesthesia were used. The concentrations of SpO 2 were monitored during the operation. A dosage of 1-2mg·kg -1 body weight was used for resuscination of the patients after the operation. Results: A total of 100 cases of operation were performed using the regime of anesthetic intervention described above. A 100% of success rate was achieved and no death occurred during the operation. Conclusion:Significant improvement of safety in anesthesia of the neonates at high risk during surgical operation can be achieved with sufficient preoperational preparation, adequate monitoring during the operation and rational use of anesthetics as well as restrict selection of suitable anesthetical interventions.