摘要
目的探讨婴幼儿快速型心律失常行导管射频消融术(radiofrequencycatheterablation,RFCA)的麻醉特点及管理。方法回顾性分析2004年8月~2016年8月123例在我院接受心内电生理检查及RFCA的快速性心律失常患儿的临床资料。患儿均给予静脉吸入复合麻醉联合喉罩控制通气,记录患儿的手术成功率、手术时间、麻醉时间及相关并发症。结果123例患儿中共有109例(88.6%,109/123)完成了RFCA,消融成功104例,成功率95.4%(1041109);平均手术时间为(s6.38±33.52)min,平均麻醉时间为(92.28±37.19)min;麻醉后因未能诱发出心动过速导致未行消融术共计6例(4.9%,6/123o术后拔管苏醒期发生躁动5例,为拔出喉罩后喉痉挛,其中4例患儿加深麻醉后喉痉挛解除,自主呼吸恢复后返回病房,1例患儿加深麻醉后喉痉挛未能解除,经再次插入气管插管,带管返ICU,3h后顺利拔管返回病房。3例患儿术后出现恶心呕吐。结论婴幼儿快速性心律失常行RFCA的麻醉管理要求高、风险大,麻醉相关并发症发生率较高。良好的循环、气道管理,合理的麻醉药物选择,是此类手术麻醉的管理要点。
Objective To evaluate the features and management methods of anesthesia for infants with rapid arrhythmia undergoing radiofrequency catheter ablation. Methods One hundred and twenty-three infants with rapid arrhythmia undergoing radiofrequency catheter ablation were retrospectively analyzed in this study. All infants were given combined anesthesia while using laryngeal mask to manage airway. Record the success rate of operation, anesthesia time, operation time and related complications. Results Of the included 123 cases, the operation of 109 cases were finished with successful rate of 95.4%(104/109). The mean operation and anesthesia time were (86.38±33.52) min and (92.28±37.19) min respectively. The operation of 6 cases were not performed due to unsuccessful induction of tachycardia. There are 5 cases of postoperation agitation, 4 cases of laryngeal spasm were disappeared after deepen anesthesia. 1 case of larygeal spasm was discharged to patient unit. The laryngeal spasm was disappeared until intubation for 3 h. There are total 3 cases of postoperation nausea and vomiting. Conclusions Radiofrequency catheter ablation of infants and young children with rapid arrhythmia had high risk and high incidence of anesthesia related complications. Good management of hemodynamics and airway, reasonable selection of narcotic are the key management of this kind of anesthesia.
作者
杨永涛
郭孟孟
张东亚
Yang Yongtao Guo Mengmeng zhang Dongya(Deportment of A nesthesiology, the First Hospital of Tsinghua University, Beijing 100016, China(Yang YT, Guo MM, Zhang DY)
出处
《国际麻醉学与复苏杂志》
CAS
2017年第10期891-894,898,共5页
International Journal of Anesthesiology and Resuscitation
关键词
婴幼儿
心律失常
射频导管消融术
Infants
Arrhythmia
Radiofrequency catheter ablation