【作者】 李丽莉；

【Author】 Li Lili Henan Province People’s Hospital operating room 450003

【机构】 河南省人民医院眼科手术室；

【摘要】 研究目的探讨喉罩通气联合异丙酚靶控输注在眼科小儿全麻手术中的护理配合。研究方法选择2008年6月至2011年12月我院眼科围手术期患儿1412例,其中男964例,女448例;年龄5个月-12岁,体重8-32公斤,采用ASAⅠ-Ⅱ级择期手术拟行喉罩置入全身麻醉的患儿,所有手术患儿术前常规禁食6小时,禁水4小时,术前30分钟肌肉注射阿托品0.02mg/kg。根据患儿年龄体重分别选择1.5﹟、2﹟及2.5﹟等型号喉罩。麻醉前建立静脉通道,术中连接TCI输液泵输注异丙酚4mg/﹙kg﹒h﹚,瑞芬太尼0.2~0.3ug/﹙kg﹒min﹚,维持麻醉,实施手术。研究结果术中患儿循环、呼吸功能稳定,术后随访无一例喉头水肿、咳嗽等并发症发生。护理的应用喉罩通气是介于面罩和气管插管之间的一种通气道,由于喉罩其使用便捷和有效已被广泛接受,针对眼科手术患儿解剖特点、眼科手术的麻醉特点,安全有效的护理配合可以减少喉罩通气联合异丙酚靶控输注麻醉风险,不会对喉头、气管造成损伤,操作中对眼压影响小,很少发生呛咳反应,有效地减少全身麻醉风险,确保患儿手术顺利进行。更多还原

【Abstract】 Objective.To investigate nursing coordination of the laryngeal mask airway combined with propofol target-controlled infusion anesthesia in pediatric ophthalmology surgery. Methods. To sum 1412 children cases (964 men and 448 women; the age of 5 months -12 years old; 8-32 kg of body weight) for pediatric ophthalmology surgery under general anesthesia with laryngeal mask airway from June 2008 to December 2011 in our hospital. All children using the ASA I - II elective surgery , and undergoing preoperative routine of six hours fasting, 4 hours water deprivation, preoperative intramuscular injection of atropine(0.02mg/kg). Establishment of intravenous access connected TCI infusion pumps for intraoperative infusion of propofol to 4mg / (kg.h the), remifentanil 0.2 ~ 0.3ug / (kg.min) to maintain anesthesia in the surgery with respectively 1.5 #, 2 # and 2.5 # Model laryngeal mask airway based on weight and age in children. Results. Circulation and respiratory function stability of children in operation process and no one postoperative occurred laryngeal edema, cough and other complications removing Intraoperative and, and post operative without a case of laryngeal mask airway. Nursing experience. Laryngeal mask is a way between the mask and tracheal intubation due to convenient, effective using, and having been widely accepted for ophthalmic surgery in children. Safe and effective nursing coordination according to children characteristics of anatomy and eye surgery anesthesia can reduce the risk of general anesthesia with the laryngeal mask airway to ensure pediatric ophthalmology surgery smooth, and decrease the effect of the operation on intraocular pressure and no one having damaged the larynx, trachea and cough response. Nursing coordination general anesthesia with laryngeal mask airway to ensure that children with ophthalmology surgery carried out smoothly.更多还原