| 赵振海,张文斌,李亚琴,吴 芳,林 澄.快通道麻醉在小儿先天性心脏病手术中的应用及对镇静、镇痛效果的影响[J].,2019,19(6):1160-1163 |
| 快通道麻醉在小儿先天性心脏病手术中的应用及对镇静、镇痛效果的影响 |
| Application of Fast Track Anesthesia in Pediatric Congenital Heart Disease and Its Effects on Sedation and Analgesia |
| 投稿时间：2018-07-25 修订日期：2018-08-20 |
| DOI：10.13241/j.cnki.pmb.2019.06.035 |
| 中文关键词: 快通道麻醉 小儿先天性心脏病 常规麻醉 镇静 镇痛 |
| 英文关键词: Fast track anesthesia Pediatric congenital heart disease General anesthesia Sedation Analgesia |
| 基金项目:广西壮族自治区卫生厅基金项目（Z20131042）；桂林市科学研究与技术开发技术项目（20150206-1-13） |
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| 中文摘要: |
| 摘要 目的：探讨快通道麻醉在小儿先天性心脏病手术中的应用及对镇静、镇痛效果的影响。方法：选择2016年6月至2018年5月在桂林医学院附属医院进行手术治疗的小儿先天性心脏病患儿82例，按照随机数字表法分为对照组（41例）和观察组（41例），对照组进行常规麻醉，观察组则采用快通道麻醉。对比两组患儿麻醉药物用量、手术时间、阻断时间、体外循环时间、术后拔管时间、住院时间、住院费用及并发症发生情况，观察两组患儿术后12h镇静、镇痛效果。结果：观察组患儿芬太尼和罗库溴铵用量明显低于对照组（P<0.05）。两组患儿的术中各指标比较无统计学差异（P>0.05），而与对照组相比，观察组患儿术后住院时间、拔管时间均缩短，且住院费用减少（P<0.05）。观察组患儿术后12h的镇静及镇痛效果均优于对照组（P<0.05）。观察组患儿术后并发症发生率为17.07%（7/41），低于对照组的39.02%（16/41）（P<0.05）。结论：快通道麻醉可减少小儿先天性心脏病手术的芬太尼和罗库溴铵用量，不仅缩短术后拔管时间和住院时间，降低住院费用，而且可改善镇静及镇痛效果，安全有效。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the application of fast track anesthesia in pediatric congenital heart disease and its effects on sedation and analgesia. Methods: 82 children with congenital heart disease who underwent surgical treatment in Affiliated Hospital of Guilin Medical College from June 2016 to May 2018 were selected. They were divided into control group (41 cases) and observation group (41 cases) according to the random number table method. The control group received routine anesthesia, while the observation group received fast track anesthesia. The dosage of anesthetic drugs, operative time, interruption time, cardiopulmonary bypass time,postoperative extubation time, hospitalization time, hospitalization expenses and complications were compared between the two groups.The sedation, analgesic effect at 12h after operation of the two groups were observed. Results: The dosage of fentanyl and rocuronium in the observation group was significantly lower than that in the control group (P<0.05). There was no significant difference in intraoperative indexes between the two groups (P>0.05). Compared with the control group, the hospitalization time and extubation time of the observation group were shortened, and the hospitalization expenses were reduced (P<0.05). The sedative and analgesic effects at 12h after operation in the observation group were better than that in the control group (P<0.05). The incidence of postoperative complications in the observation group was 17.07%(7/41), which was lower than 39.02%(16/41) in the control group (P<0.05).Conclusion: Fast track anesthesia can reduce the dosage of fentanyl and rocuronium in pediatric congenital heart disease. It not only shortens postoperative extubation time and hospitalization time, reduces hospitalization expenses, but also improves sedative and analgesic effects, and it is safe and effective. |
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