快通道心脏麻醉与术后早期拔管及术中知晓

Fast-track cardiac anesthesia and early tracheal extubation and intraoperative awareness

目的 比较“快通道”心脏麻醉 ( fast- track cardiac anesthesia,FTCA)与传统的大剂量芬太尼麻醉对先天性心脏病病人术后清醒时间、拔除气管导管 (简称拔管 )时间和术中知晓的影响。方法 FTCA组 ( 组 )麻醉维持以异氟醚为主 ,芬太尼组 ( 组 )麻醉维持以芬太尼为主 ,观察术后清醒时间、拔管时间和术中知晓情况。结果 清醒时间和拔管时间 组均比 组短 ,差异有非常显著性 ( P<0 .0 1) ,且 组病人无拔管后再插管 ,亦无术中知晓。结论 施行“快通道”心脏麻醉有利于术后早期拔管 ,减少术后呼吸系统并发症 ,对病人的心血管系统无明显的不良影响。同时减少了病人在重症监护室 ( ICU)的停留时间 。

Objective To compare the effects of consciousness recovery (CR) time,tracheal extubation (TE) time and intraoperative awareness between fast-track cardiac anesthesia (FTCA) and large-dose fentanyl cardiac anesthesia.Methods FTCA group was maintained with isoflurane.Fentanyl group was maintained with fentanyl.CR time,TE time and intraoperative awareness were observed.Results CR time and TE time in FTCA group were shorter than those in fentanyl group (P<0.01).There was no reintubation and intraoperative awareness in FTCA group.Conclusion Administration of FTCA benefits early tracheal extubation after operation.It may reduce the complications of respiratory system,and no obvious side effects of cardiovascullar system.Therefore,it shortens the stay in intensive care unit (ICU) and reduce the medical cost.