98例肺灌洗的麻醉体会

Anesthesia experience of 98 cases of lung lavage

目的:分析大容量全肺灌洗术的麻醉安全实施全程。方法:98例患者术前皆予以0.5mg阿托品行肌注,予以相应药物使用,待患者意识消失,获得满意的肌肉松弛程度后,插入双腔导管,借助于听诊法进行初步的定位判断,双腔导管就位准确,得到满意的双肺分隔结果后,测定双肺通气与左、右单肺通气时的顺应性与气道压,持续应用丙泊酚维持麻醉,并间断性的使用芬太尼、维库溴铵,以患者实际生命体征变化相应调整麻醉深度。结果:98例患者术中麻醉皆平稳,并未见有明显的不良反应发生,且术后随访并未见有出现不适者。结论:做好术前完善的准备,术中正压通气,对大容量全肺灌洗术的麻醉是安全可行的。

Objective:To analyze the large capacity anesthesia safety whole lung lavage for the implementation of the whole.Methods:98 cases of patients with preoperative were 0.5 mg atropine intramuscular injection, shall be corresponding drug use and treat patients consciousness disappears, a satisfactory degree of muscle relaxation, insert the double lumen catheter, judging by auscultation method carries on the preliminary positioning, accurate double lumen catheter in place, the double lung separation of satisfactory results after determination of double lung ventilation with right and left single lung qi compliance and airway pressure, continuous application of propofol maintained anesthesia, and the use of intermittent fentanyl and vecuronium bromide Ammonium to actual vital signs change accordingly anesthetic depth.Results:98 cases of patients with intraoperative anesthetic is smooth, did not have obvious adverse reactions occur, and postoperative follow-up did not see any discomfort.Conclusion:the perfect preparation for the operation,surgery is pressure ventilation, the large capacity of whole lung lavage anesthesia is safe and feasible.