【摘要】 目的 :探讨异丙酚用于心内直视手术后早期拔管的可行性与安全性。方法 :3 3例单纯房间隔缺损 (ASD)和室间隔缺损 (VSD)心脏病变患儿 ,以异丙酚 2 5～ 3mg/kg诱导 ,芬太尼 5 μg/kg、潘库溴铵0 1mg/kg完成气管插管。异丙酚 4mg/(kg .h)静滴并低浓度安氟醚吸入维持麻醉。拔管指征 :意识完全清醒 ,血流动力学稳定 ,肌力恢复良好 ,自主呼吸平稳 ,血气基本正常。结果 :术终 1h内拔管 10例 (3 0 % ) ,1～2h内拔管 15例 (45 % ) ,余 3h内拔管。患儿苏醒期平稳无烦躁 ,拔管后安静无复睡。结论 :异丙酚作为主要麻醉药适于心功能较好、单纯性心脏病变心内直视手术麻醉 ,并能早期拔管。更多还原

【Abstract】 Objective:To discuss the feasibility and safety of early tracheal extubation after open heart surgeries with propofol anesthesia.Methods:Thirty three children with atrial septum defect(ASD) or ventricular septum defect(VSD) were acted as subjects.Anesthesia was induced with propofol 2.5 3mg/kg iv.Fentanyl 5μg/kg and pancuronium 0.1mg/kg were given iv to facilitate endotracheal intubation.Propofol was infused continuously to maintain anesthesia at a rate of 4mg/(kg.h) combined with low concentration of enflurane inhalation.Extubation criteria included clear consciousness,stable circulation,recovered muscle strength and satisfied respiration.Results:Ten cases (30%) were extubated in 1 hr,15 cases(45%) between 1 and 2 hr and others in 3 hr after operation.All the children recovered quickly,stably,quietly and without resleeping.Conclusion:For the purpose of early extubation,propofol can be safely used in simple open heart surgeries as the major anestheitic because of its short half life time and without accumulation.更多还原