婴幼儿气管异物取出术的麻醉方法改进(附58例报告)

Improvement on anesthetic method of removal of foreign bodies in infants and children(A report of 58 cases)

目的研究在婴幼儿气管异物取出术行全身麻醉时应用肌松药和支气管镜侧孔控制呼吸的通气方法的可行性。方法58例因气管异物需在支气管镜下手术取出的婴幼儿采用中效肌松药罗库溴铵0.3mg/kg及静脉全麻药丙泊酚1mg/kg进行全身麻醉,并以支气管镜侧孔连接麻醉机使用较大的潮气量10～15ml/kg行手控通气,术中连续监测患儿心率(HR)、血压(NBP)、脉搏血氧饱和度(SpO2)、心电图(ECG)变化。结果全组患儿术中无缺氧表现,生命体征平稳,未见屏气和气管痉挛等并发症发生,术后恢复良好。结论在婴幼儿气管异物取出全身麻醉时,使用肌松药罗库溴铵及经支气管镜侧孔控制呼吸的通气方法是安全、效果良好的,值得推广应用。

Objective To study the feasibility of using muscle relaxant and ar tificial ventilation through the side port of fibrobronchoscope during general a nesthesia for removal of tracheal foreign bodies in infants and children.Methods 58 cases with tracheal foreign bodies were removed by fibrobronchoscope,which r ocuronium 0.3mg/kg and propofol 1mg/kg were given introvenously during general a nesthesia. Manual ventilation with more high tidal volume(10～15 ml/kg)were achi eved by anesthesia machine connected to the side port of fibrobronchoscope.Heart rate(HR),noninvasive blood pressure(NBP),pulse oxygen saturation(SpO2)and elect rocardiogram(ECG) were monitored continuosly during the operation. Results No an y hypoxia,dramatic fluctuation of vital signs,breath holding and trachospasm wer e found in all cases.Furthermore,all patients recuperated well.Conclusion It is safe and effective to use muscle relaxant and artificial ventilation through the side port of fibrobronchoscope during general anesthesia for removal of trachea l foreign bodies in infants and children.This method is worth in popularizing.