异丙酚与芬太尼复合静脉麻醉在小儿气管异物取出术中的应用

目的：探讨异丙酚与芬太尼复合静脉麻醉用于小儿气管异物取出术的应用效果、血流动力学变化及并发症情况。方法：40例气管异物的患儿，芬太尼0．004mg/kg，异丙酚2mg／kg静脉诱导，咽喉部表麻后置入直达喉镜；经直达喉镜的吸氧孔接高频喷射通气管，术中根据患儿体动情况静注异丙酚1～1．5mg／kg，异物取出后停止给药，记录入室、麻醉后、手术开始、及术毕时的MAP、HR、SPO2，记录术中喉痉挛、分泌物、手术操作满意度情况，术后患儿苏醒时间、有无惊厥、躁动，恶心、呕吐等并发症。结果：40例患儿麻醉成功，均顺利完成异物取出术，术中血流动力学变化稳定，术后苏醒快，并发症少。结论：异丙酚与芬太尼复合静脉麻醉可满足小儿气管异物取出的手术，麻醉安全、平稳，并发症少。

The Application of Propofol and Fentanyl Combined Intravenous Anesthesia in Operation of Foreign Body Removal from Infant Respiratory Tract

Objective：To search for the application effect, hemodynamies changes and complications of propofol and fentanyl combined intravenous anesthesia used in operation of foreign body removal from infant respiratory tract. Methods： 40 infant patients with foreign body in respiratory tract were intubated with direct laryngoscope after intravenous anesthesia induction with 0.004 mg/kg fentanyl and 2mg/kg propofol and pharyngeal surface anesthesia, with frequency jet ventilation tube connected with the hole of the laryngoscope which is used for inhaling oxygen. In operations 1 - 1.5mg/kg propofol was added according to body movement. Drugs were stopped after foreign bodies were removed. MAP, HR and SPO2 were measured when entering operation room, after anesthesia, at the beginning of the operation and at the end of the operation. During operations the incidence of laryngospasm and gland secreted and the satisfaction of the operation were recorded. And the time of awake and complications such as convulsion, restlessness, nausea and vomiting after operation were also recorded. Results： Anesthesia and operations of 40 cases all succeeded with stable hemodynamies, fast awake and few complications. Conclusion： Propofol and fentanyl combined intravenous anesthesia is satisfactory for operation of foreign body removal from infant respiratory tract because of its safety, stability and few complications.