不同麻醉方法在小儿漏斗胸矫形术中的应用

目的　总结不同麻醉方法在小儿漏斗胸矫形术的应用。方法　将 112例先天性漏斗胸患儿随机分为单纯肌注 +静注氯胺酮全麻组 (KK组 )、全麻气管内插管组 (G组 )及全麻 +硬膜外神经阻滞组 (GE组 )。结果　三组麻醉效果均满意 ,KK组中 1例根据术式要求途中改为气管插管全麻 ,G组和GE组术毕均按时拔管。G组芬太尼总量为 5～ 8(6 .0 1± 1.6 8) μg/kg ,明显小于GE组 3～ 6 (4± 1.2 3) μg/kg](P <0 .0 1)。结论　小儿漏斗胸矫形术的麻醉方法应根据病情灵活选用。幼儿期的简单手术不需气管内插管 ,年长儿手术以硬膜外加全麻效果好。

Apllication of different anesthetic techniques in reformative procedures of children's pectus excavatum

Objective It is to summarize the results of the different anesthetic techniques applied in reformative procedures of children's pectus excavatum. Methods 138 children with pectus excavatum were divided into three groups at random. Group KK were anesthetized with ketamine alone without endotracheal intubation. Group G were anesthetized with intravenous inhaled general anesthesia and intratracheal insufflation anesthesia. Group GE were anesthetized with general anesthesia and epidural nerve block. Results The patients in group KK experienced a smooth anesthesia. One of them received endotracheal intubation during operation. The patients in group G and group GE emerged from general anesthesia and were extubated at end of operations. The dosage of fentanyl in group G were 5 8 (6.01±1.68)g/kg and larger than that of group GE which were 3 6(4±1.23)g/kg ( P <0.01). Conclusion The anesthesia about reformative procedures of pectus excavatum can be conducted in accordance with level of procedures actively. Infants can tolerate operative manipulation without endotracheal intubation. Combined general anesthesia and epidural nerve block are the best choice in elder children.