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时间:2020-05-02
《不同麻醉方法在小儿腹腔镜手术中的应用体会.pdf》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、第l7卷第11期腹腔镜外科杂志Vol_17.No.112012年11月JOURNALOFLAPAROSCOPICSURGERYNov.2012文章编号:1009—6612(2012)11—0873一O4论著·不同麻醉方法在小儿腹腔镜手术中的应用体会赵立华,胡正坤(桓台县妇幼保健院,山东桓台,256400)【摘要】目的:对比分析不同麻醉方法对小儿腹腔镜手术患者插管及拔管前后心率、并发症情况的影响。方法:随机将56例腹腔镜手术患儿分为骶管复合气管插管全麻组(A组)、骶管复合喉罩全麻组(B组)、单纯喉罩全麻组(c组)、单纯气管插管
2、全麻组(D组),每组14例。患儿10个月~5岁,体重9.5~21kg。分别于麻醉插管后即刻、拔管前1min、拔管后即刻记录心率变化,观察拔管时有无喉痉挛、呼吸道分泌物情况,术中记录心率、血氧饱和度、呼气末二氧化碳分压及BIS值。术后2h内观察有无咽喉部疼痛不适、声音嘶哑、哭闹、咳嗽、呼吸异常及意识恢复情况。结果:B组插管后即刻、拔管后即刻对心率的影响较其他三组小,患儿术后清醒时咽喉部疼痛、咳嗽、喉痉挛、呼吸道分泌物明显减少,耐受的BIS指数更高。拔除喉罩患儿呼吸更平稳、清醒更彻底。结论:小儿腹腔镜手术行骶管复合喉罩全麻患儿麻
3、醉前后心率的变化波动较小,术后患儿清醒更彻底,并发症更少。【关键词】麻醉,全身;麻醉,气管插管;麻醉,喉罩;腹腔镜检查;儿童中图分类号:R614文献标识码:AExperienceofdifferentanesthesiamethodsduringthesurgicallaparoscopicsurgeryinchildrenZHAOLi—hua,HUZheng—kun.DepartmentofAnesthesiology,MaternalandChildHealthHospital,Huantai256400,China【A
4、bstract】0bjective:Tocompareandanalyzetheeffectofdifferentanesthesiamethodsduringpediatricsurgicallaparoscopicoperationonheartrateandcomplicationsbeforeandafterintubationorextubation.Methods:Laparoscopicoperationin56cases,wererandomlydividedintosacralcanalcompositet
5、rachealintubationingeneralanesthesiagroup(groupA),sacralcanalcombinedwithla—ryngealmaskairwayingeneralanesthesiagroup(groupB),simplelaryngealmaskanesthesiagroup(groupC),simpletrachealintuba—tiongeneralanesthesiagroup(groupD).Eachgrouphas14cases(age:10months一5years,
6、weight:9.5-21kg).Clinicalobservationontheanestheticintubationwereimmediatelyafterextubation,1minutesbeforeandimmediatelyafterextubationrespectively.Afterrecord—ingheartratechanges,laryngealspasm,respiratorysecretions,intraoperativerecordingofheartrate,oxygensaturat
7、ion,end—tidalcarbondioxidetensionandBISvalueweredetected.Throatpain,hoarseness,crying,cough,respiratoryabnormalitiesandconsciousnessrecover-ywereobservedwithin2hpostoperatively.Results:theeffectofimmediatelyafterextubationandimmediatelyafterextubationinGroupBontheh
8、eartratewaslessthanthatingroupA,groupC,groupD.Theincidenceofchildrenpostoperativeawakethroatpain,coughla—ryngospasmandrespiratorysecretionwasmark
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