标题：小儿先心病导管麻醉体会

      作者：吕 淞，王 涛
    （海南省农垦总医院麻醉科，海口 海南 570311）

      卷次： 2013年24卷1期

      【摘要】 目的 介绍小儿先天性心脏病(先心病)患儿导管室内的麻醉体会。方法 50例ASAⅠ~Ⅲ级的
先心病患儿静注硫酸阿托品0.02 mg/kg、盐酸氯胺酮2 mg/kg做基础麻醉，入室后肌注盐酸氯胺酮6 mg/kg，静脉
追加咪达唑仑 0.1 mg/kg，盐酸氯胺酮 1 mg/kg，并予面罩吸氧。术后入住麻醉苏醒室观察至患儿完全清醒。
结果 患儿血流动力学正常，能很好的耐受手术。诱导苏醒平顺，所有患儿无麻醉并发症发生。结论 氯胺酮
是安全、有效、经济的麻醉选择。麻醉处理关键在于熟悉病理生理，减少呼吸抑制的发生。

      【关键词】 小儿先心病；介入；氯胺酮；咪达唑仑

      【中图分类号】 R725.4 【文献标识码】 A 【文章编号】 1003—6350(2013)01—0100—02


Anesthesia of children with congenital heart diseases in intervention clinic.
LV Song，WANG Tao. Department of
Anesthesia, Hainan Provincial Nongken Hospital, Haikou 570311, Hainan, CHINA

【Abstract】 Objective To introduce our experience in intervention clinic anesthesia of children with congeni-
tal heart diseases. Methods Fifty ASAⅠ~Ⅲ children undergoing interventional therapy were selected. Children
were injected with atropine sulfate (0.02 mg/kg) and ketamine (2 mg/kg) for anesthesia induction. When patients were
in intervention clinic, ketamine (6~8 mg/kg) were given intromascularly for maintainence. During the procedure, ket-
amine (1~2 mg/kg) and midazolam (0.1 mg/kg) were given to deepen anesthesia, with oxygen inhalated by mask.
Results Children were able to meet the surgical anesthesia, with the quick induction and wake up and no obvious
side effects and complications. Conclusion Ketamine anesthesia, in children with congenital heart disease in the in-
terventional treatment was safty. It is important for the anesthesiologists to be familiar with the pathophysiology of
heart diseases, supply sufficiant oxygen, keep airway open, and unobstructed.

      【Key words】 Congenital heart disease; Interventional treatment; Ketamine; Midazolam
·经验交流·