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目的探讨低体重婴儿因先天性心脏病手术的麻醉效果。方法主要分为3组:Ⅰ组20例,咪唑安定或地西泮0.15~0.4mg/kg、潘库溴铵或维库溴铵0.1~0.15mg/kg、芬太尼5~10μg/kg。Ⅱ组10例,与1组相比,芬太尼用量加大至20~40μg/kg,其他相同,Ⅲ组10例,γ-羟基丁酸钠(-γOH)50~85mg/kg,潘库溴铵或维库溴铵0.1~0.15mg/kg,芬太尼5~10μg/kg。诱导后行气管插管,间歇正压通气(IPPV),潮气量12~15m l/kg,频率25~35次/m in,吸呼比1:2。结果Ⅰ、Ⅲ组诱导气管插管后,SBP、DBP、HR、RPP均无明显改变(P>0.05);Ⅱ组诱导插管后SBP、RPP显著降低(P<0.01),DBP降低明显(P<0.05),HR虽有减慢的倾向,但差异无统计学意义(P>0.05)。结论苯二氮蕈类药与大剂量芬太尼配伍已广泛用于各类心脏手术的麻醉。由于咪唑安定的水溶性、起效快、作用时间短及对组织的刺激性小的特点,临床麻醉中已有取代安定的趋势。
Objective To investigate the anesthetic effects of low birth weight infants with congenital heart disease. The method is divided into three groups: group Ⅰ 20 cases, midazolam or diazepam 0.15 ~ 0.4mg / kg, pancuronium or vecuronium 0.1 ~ 0.15mg / kg, fentanyl 5 ~ 10μg / kg. Ⅱ group of 10 cases, compared with the 1 group, fentanyl dosage increased to 20 ~ 40μg / kg, the other the same, Ⅲ group of 10 cases, γ-hydroxybutyrate (-γOH) 50 ~ 85mg / kg, Pan library Bromide or vecuronium 0.1 ~ 0.15mg / kg, fentanyl 5 ~ 10μg / kg. Tracheal intubation, intermittent positive pressure ventilation (IPPV), tidal volume of 12 ~ 15m l / kg, frequency of 25 ~ 35 times / min, and respiratory ratio of 1: 2 were induced after induction. Results After intubation, the SBP, DBP, HR and RPP in group Ⅰ and group Ⅲ were not significantly changed (P> 0.05). The SBP and RPP in group Ⅱ were significantly decreased (P <0.01) <0.05). Although HR tends to slow down, the difference was not statistically significant (P> 0.05). Conclusion Benzodiazepines and high-dose fentanyl compatibility has been widely used in various types of cardiac surgery anesthesia. As a result of midazolam water-soluble, fast onset, short duration of action and the characteristics of small irritant tissue, clinical anesthesia has replaced the stability of the trend.