22例心脏手术的麻醉及围术期处理

The experience of anesthesia and management for 22 cases of cardiac surgery

[目的 ]总结 2 2例心脏病心内直视手术的麻醉体会 .[方法 ]用咪唑安定、芬太尼、依托咪脂、得普利麻及维库溴铵诱导麻醉后行气管插管及机械通气 ,并吸入异氟醚 ,同时监测平均动脉压、心电图、中心静脉压、呼气末二氧化碳分压、异氟醚、体温、尿量和血液气体 ,术后 1～ 3h拔出气管插管 .[结果 ]2 2例病人中除 1例在停止体外循环后死亡外 ,其余 2 1例麻醉平稳 ,术后早期拔出气管插管 ,无 1例发生肺部并发症 .[结论 ]行体外循环下心内直视手术时 ,在保证麻醉和血流动力学平稳的情况下 ,术后早期拔出气管插管可减少肺部并发症的发生 。

OBJECTIVETo sum up the experience of anesthesia for 22 cases of cardiac disease performed with open heart surgery in order to provide the experience for anesthesia in the future.?METHODS?After rapid induction with midezolam, fentanyl, etomidate, propofol and vecorunium, intubation was performed and connected with anesthesia machine used for ventilater. It was monitored that the MAP, ECG, CVP, P Et CO 2 , Isoflurane, body temperature, urine and blood gas and the catheter were extubated between 1 and 3 hour after operation.?RESULTS?Of 22 cases, the effects of anesthesia were good, the catheter were removed earlier and there had no lung complication in the 21 cases, but only 1 case was dead after CPB.?CONCLUSION?During the open heart operation, if the anesthesia and hemodynamic indices were balanced, the lung complication can be reduced under the circumstance of earlier extubation after operation.