小儿深麻醉下气管拔管的研究进展

Research progresses in tracheal extubation under deep anesthesia in children

随着小儿手术的日益增多,小儿全身麻醉气管插管增多,拔管相关的并发症相应增多,气管拔管的方法和时机的选择日益受到麻醉医师关注。如何在保证患儿安全的前提下使患儿在较为舒适的环境下苏醒,是小儿麻醉医师不断追求的目标。已有大量临床研究证实,深麻醉下拔管可减少患儿麻醉苏醒期呼吸道并发症,减轻血流动力学波动,减少拔管后患儿躁动,使患儿在较为舒适的状态下度过麻醉苏醒期。文章就深麻醉下拔管对机体的影响、拔管方法和用药及局限性等方面进行综述。

With the increasing number of pediatric surgeries,pediatric tracheal intubation under general anesthesia increases,and the complications associated with extubation increase.Therefore,the choice of timing of tracheal extubation is increasingly con-cerned by anesthesiologists.How to wake up children in a more comfortable environment under the premise of safety is the goal pur-sued by pediatric anesthesiologists.A large number of clinical studies have confirmed that tracheal extubation under deep anesthesia can reduce respiratory complications,relieve hemodynamic fluctuations and decline child agitation after extubation in the anesthesia re-covery period,and enable children to survive the recovery period of anesthesia in a more comfortable state.This article reviews the ef-fects of deep anesthesia extubation on the body,methods of extubation,medication,and limitations.