基层医院静吸复合麻醉用于心内直视手术426例报告

目的总结426例心脏患者心内直视手术的麻醉处理体会。方法用咪达唑仑、芬太尼、依托咪酯、维库溴铵麻醉诱导行气管插管后机械通气,并间断吸入异氟醚维持。同时监测心率、有创动脉压、动态心电图、中心静脉压、体温、尿量、血糖、血氧饱和度、血气分析和电解质。维持良好的麻醉深度和心肌供耗氧平衡。结果 426例患者中除8例在停止体外循环后死亡外,其余418例麻醉平稳,术后顺利拔出气管导管,康复出院。有12例发生肺部并发症,经过治疗后痊愈。结论行体外循环下心内直视手术患者,选择静吸复合麻醉是安全的麻醉方法。

The application of combined intravenous and inhalation anesthesia to open heart surgery with extracorporeal circulation in primary hospital (report of 426 cases)

Objective To summarize the experience of application of combined intravenous and inhalation anesthesia to open heart surgery with extracorporeal circulation in 426 cases in primary hospital.MethodsIntubation and mechanical ventilation was administrated after induction of anesthesia with midazolam,fentanyl,etomidate and vecuronium.And isoflurane was inhaled discontinuously to maintain the anesthesia status.Heart rate,invasive blood pressure,holter,central venous pressure,temperature,urine volume,blood glucose,degree of blood oxygen saturation,arterial blood gas analysis and electrolyte were all monitored simultaneously.The appropriate depth of anesthesia and myocardial oxygen consumption for balance were maintained with caution.Results8 cases passed away after cessation of extracorporeal circulation in 426 cases,and the other 418 cases experienced stable anesthesia with uprooting the endotracheal tube and recovered and be discharged from hospital.Pulmonary complications were observed in 12 cases and were all cured.ConclusionCombined intravenous and inhalation anesthesia was safe to open heart surgery with extracorporeal circulation.