小儿声带沟切开加整复术麻醉方法的探讨

目的:探讨小儿声带沟切开加整复术的麻醉处理方法。方法:对28例声带沟患儿采用静脉复合麻醉加高频喷射控制呼吸(HFJV)下行声带沟切开加整复术,记录患儿在麻醉诱导前、置入支撑喉镜即刻、置入支撑喉镜后5min及退出支撑喉镜后2min时HR、SBP、SaO2的变化,并记录患儿苏醒时间。结果:本组所有患儿术野显露充分,手术进行顺利,术中无缺氧及CO2蓄积;术后苏醒迅速,停药后3~6min内患儿完全清醒,醒后无复睡及任何不适。5例患儿在安置支撑喉镜时HR明显下降,与诱导前相比,差异有统计学意义(P<0.05),静脉注射阿托品0.01mg/kg,1min后缓解,HR恢复正常;BP在置入支撑喉镜时与诱导前相比明显上升(P<0.05),2~3min后即恢复正常。结论:静脉复合麻醉加HFJV用于小儿声带沟切开加整复术,安全、可靠,是适宜的麻醉处理方法。

Anaesthesia method in the operation of voice sulus in children

OBJECTIVE: To explore the anaesthesia method in the operation of voice sulus in children. METHOD: Before operation about 30 minutes, the patient was injected Atropin 0.02 mg/kg ( the dose of maximum < or = 0.5 mg), next to inject midazolam (0.08 mg/kg), scoline (2 mg/kg) into vein, then the operator put the direct laryngoscope to perform operation. The anaesthetist put a tube to subgottis about 1.5-2.0 cm through the laryngoscope, and the end of the tube was linked to respiratory machine (TKP-400), the pressure of oxygen is 30-50 kPa, frequency is 100-120 min. The anaesthesia maintain was injected by 0.2% disoprofol and 0.2% scoline 6-8 ml/(kg x h). The varies of HR, BP before anesthesia, when putting the laryngoscope and 5 minutes after that, 2 minutes after quilting laryngoscope and at the recovering time were recorded. RESULT: All the operations were successful, none of short of oxygen and none of accumulating of CO2. The recovering were quickly within 5-6 minutes after stopping anaesthesia. CONCLUSION: The anaesthesia of injecting THEJV in vein in operating voice sulus in children is safe and suitable.