CAJ | 학술논문

目的探讨埃博斯坦畸形(Ebstein's anomaly)矫治术的麻醉处理方法.方法回顾分析清华大学第一附属医院麻醉科2004年3月至2010年9月接受手术治疗的79例Ebstein畸形患者的麻醉处理情况.全部病例采用静吸复合全身麻醉.麻醉诱导采用咪达唑仑,舒芬太尼及哌库溴铵或维库溴铵静注.麻醉维持给予间断注入舒芬太尼及咪达唑仑,并酌情吸入异氟烷辅助麻醉.结果麻醉平稳,所有患者术后症状明显改善,围手术期无一例死亡.结论 Ebstein畸形患者需加强麻醉前评估,选择合理的麻醉药物,避免血流动力学剧烈波动,维持合适的肺血管阻力,避免心律失常.
목적 탐토애박사탄기형(Ebstein's anomaly)교치술적마취처리방법.방법 회고분석청화대학제일부속의원마취과2004년3월지2010년9월접수수술치료적79례Ebstein기형환자적마취처리정황.전부병례채용정흡복합전신마취.마취유도채용미체서륜,서분태니급고고추안혹유고추안정주.마취유지급여간단주입서분태니급미체서륜,병작정흡입이불완보조마취.결과 마취평은,소유환자술후증상명현개선,위수술기무일례사망.결론 Ebstein기형환자수가강마취전평고,선택합리적마취약물,피면혈류동역학극렬파동,유지합괄적폐혈관조력,피면심률실상.
Objective To summarize the experience in anesthetic management for correction of Ebstein's anomaly.Methods A total of 79 patients with Ebstein's anomaly who underwent surgical repair in our hospital during the time from March 2004 to September 2010 were retrospectively summarized for their anesthetic management.Anesthesia was done for the patients undergoing correction of Ebstein's anomaly.The adults patients were premedicated with intramuscular morphine 0.2 mg/kg and diazepam 0.05 mg/kg.The children patients were premedicated with intramuscular ketamine 5 -8 mg/kg and atropine 0.05 -0.20 mg.General anesthesia was induced with midazolam 0.1 - 0.2 mg/kg,etomidate 0.2 - 0.3 mg/kg,sulfentanil 1.0 - 1.5 μg/kg,pipecuronium or vecuronium 0.1 - 0.2 mg/kg,and maintained with isoflurane inhalation and intermittent iv.midazolam and sulfentanil.Results Anesthetic course was smooth.The symptom in all cases was improved significantly after operation.No patients died during perioperative period.Conclusion The key points for the anesthetic management of Ebstein's anomaly include precise preoperative evaluation,steady hemodynamic,proper maintenance of suitable oulmonary vascular resistance and cardiac function.