effect of anaesthesia、complication and palinesthesia time were Observed. Results: Anaesthesia
was successful and rigid bronchoscope was inserted smoothly at one time( 一次) in all patients.
The minimum SpO
2
in group B was lower than that in group A(P<0.01); The cases of severe
breathholding and bucking after inserting bronchoscope were 1 in group A and 5 in group B;
Occurrence of submaxilla relax and glossocoma was observed in all patients in group B while it
was 1 in group A, it was significantly more in group B than that in group A(P<0.01). Laryngeal
stridor and dyspnea in inspiration when holding submaxilla were observed in 12 patients in group
B and no occurrence in group A, it was notablely more in group B than that in group
A ( P<0.01 ) . Comparing with group A, resistance time after surgery in operating room and
palinesthesia time was significantly longer in group B ( P<0.01 ) . Conclusion: Propofol TCI
combined trachea topical anaesthesia is safe, pragmatic and can be control for tracheobronchial
foreign body removal in children.
【 Keywords 】 Propofol; Drug delivery systems; Topical anaesthesia; Infant; Trachea;
Foreign body
婴幼儿气管异物取出术是临床常见的急症手术,麻醉不当是引起严重并发症的原因
之一(1)。气管内操作所需麻醉深度与产生明显呼吸抑制的麻醉深度接近,目前临床常用
的保留自主呼吸的方法因麻醉深浅难以控制,均存在一定的缺点。本研究拟观察采用异丙
酚靶控输注联合气管表面麻醉应用于婴幼儿气管支气管异物取出术的麻醉效果和安全性 ,
并与氯胺酮复合 γ-羟基丁酸钠麻醉比较。
资料与方法
一般资料 经确诊为气道、支气管异物的患儿 40 例,随机分为 A 组和 B 组,每组 20
例。A 组为异丙酚靶控输注+气管表面麻醉,B 组为传统静脉组,即传统氯胺酮+γ-羟基丁
酸钠麻醉。排除患儿年龄>36 个月、异物误吸时间>2 周病例和伴三凹症等严重呼吸困难病
人和紫绀病人。本研究经本院伦理委员会批准,患儿家属在术前均签署知情同意书。
麻醉方法 A 组合作患儿抱入手术室后开放上肢静脉,不合作患儿给予面罩吸入七
氟烷麻醉,无挣扎后开发上肢静脉,静脉注射阿托品 0.01mg/kg 和地塞米松 5mg。经三通
在静脉输液的前端连接异丙酚靶控输注泵(北京思路高公司,MARSH 模型),采用效
应室靶控。停吸入麻醉,面罩持续给纯氧,异丙酚靶控浓度从 3ug/ml 开始诱导,待升到