我国首例活体部分小肠移植术的麻醉

总结我国首例活体部分小肠移植术的麻醉。1例18岁男性患者，因肠扭转致肠坏死，仅存残余小肠40cm，完全靠肠外营养维持生理需要。拟行活体部分小肠移植术，供体为患者父亲。麻醉诱导采用静脉注射咪达唑仑、普鲁泊酚、芬太尼和阿曲库铵，行气管插管接麻醉呼吸机行机械通气，维持正常的碳酸血症。持续吸入异氟烷和氧气，泵注普鲁泊酚，间断注射芬太尼和阿曲库维持麻醉。术中密切监测血流动力学参数，根据手术刺激强度和血流动力学变化调节麻醉深度，维持有效循环血量、电解质和酸碱平衡。结果供体和受体的手术过程均顺利，分别持续3.5h和11.5h，术中生命体征维持稳定。术毕清醒后拔除气管导管。

ANESTHESIA FOR THE FIRST CASE OF LIVING SMALL BOWEL TRANSPLATATION IN CHINA

This paper is to review the anesthetic procedure for the first case of living small bowel transplantation in China. A 18 year old male patient,who had only 40cm bowel left because of small bowel necrosis after volvulus,requiring total parenteral nutrition to satisfy the physiological need,underwent a living small bowel transplantation.The donor was his father.Anesthesia was induced with intravenous midazolam,propofol,fentanyl,and atracurium.The trachea was intubated and the lungs were ventilated to maitain normocapnia.Anesthesia was maintained with isoflurane in oxygen enriched air and supplemented with infusion of propofol,bolus administration of fentanyl and atracurium.During the operation,hemodynamic parameters were closely monitored.The depth of anesthesia was adjusted based on the surgical stimulation and hemodynamic changes.The blood volume,electrolyte balance and acid base equilibrium were maintained.The surgery of both the donor and the recipient went smoothly,and lasted for 3 5h and 11 5h,respectively.The vital signs were maintained stable during the operation.The patient was extubated after emergence from anesthesia postoperatively.