婴幼儿择期手术实行常态化吸入麻醉下颈外静脉留置的可行性

目的探讨婴幼儿术前补液采用吸入麻醉后颈外静脉留置针一法的效果和安全性。方法把需要实行择期手术的40例婴幼儿按抛币法随机分两组:试验组(A组)和对照组(B组),各20例。A组吸入8%七氟醚2 min后,选择右颈外静脉穿刺留置套管针输液;B组按常规选择外周暴露最清晰的静脉穿刺输液。监测记录两组患儿在静脉穿刺过程中的BP、HR、R和SpO2变化,穿刺的次数、耗时及术后24 h患儿口述对手术有恐惧感的例数(心理阴影)。结果两组患儿术前的一般情况无显著性差异(p>0.05),A组麻醉至穿刺完毕时段的生命体征较B组平稳,A组一次性穿刺的成功率明显高于B组(p<0.01),术后24 h随访患儿口述对手术的恐惧感A组例数明显少于B组(p<0.01)。结论择期手术的婴幼儿术前输液选择吸入麻醉下颈外静脉进行,不但穿刺成功率高,耗时短,而且术后心理阴影少,值得倡议推广。

FEASIBILITY OF EXTERNAL JUGULAR VEIN CATHETERIZATION UNDER INHALATION ANESTHESIA IN SELECTIVE OPERATION OF INFANTS

Objective To discuss the efficacy and security of external jugular vein catheterization under in- halation anesthesia in infants receiving preoperative fluid infusion. Methods 40 infants were randomly divided into experimental group （ A group） and control （ B group） by coin flip, 20 cases in each group. Inhalation anesthesia was induced with 8% sevoflurane in group A. 2rain later, the infusion was administered through fight external jugular vein catheterization; for group B, the infusion was administered via the most clearly exposed vein by puncture. BP, HR, R and SpO2 were monitored in the two groups. The times of puncture, time consumption and the cases reporting pho- bia （psychological shadow） 24 h after operation. Results The general preoperative conditions of the infants in both groups did not show significant difference （p 〉 0. 05 ）. The vital signs of group A from anesthesia to the end of punc- ture were more stable than group B ; the one - time success rate of puncture in group A was significantly higher than that in group B （p 〈0. 01 ）. The cases reporting phobia 24 h after operation in group A were significantly smaller than that in group B （p 〈 0. 01 ）. Conclusion External jugular vein catheterization under inhalation anesthesia in selective operation of infants receiving preoperative fluid infusion had a higher one - time success rate of puncture, less time consumption and less psychological shadow, and therefore is recommended for popularization.