新生儿胸外科手术的麻醉

Anaesthesia for neonatal thoracic surgery.

作者信息

Tobias Joseph D

机构信息

The Division of Pediatric Critical Care/Pediatric Anaesthesiology, The Department of Child Health, The University of Missouri, Columbia, MO, USA.

出版信息

Best Pract Res Clin Anaesthesiol. 2004 Jun;18(2):303-20. doi: 10.1016/j.bpa.2003.11.005.

DOI:10.1016/j.bpa.2003.11.005

PMID:15171506

Abstract

Anaesthetic care during thoracic surgical procedures in neonates combines components of the knowledge bases of neonatal anaesthesia with those of thoracic anaesthesia. This chapter reviews the principles of anaesthesia during thoracic surgery in neonates including the pre-operative evaluation, anaesthetic induction techniques, maintenance anaesthesia and options for post-operative analgesia. In addition, given the need to provide optimal surgical visualisation during these procedures, one-lung ventilation (OLV) may be required. Techniques to provide OLV in the neonate and the principles of anaesthetic care during OLV are reviewed. Finally, specific scenarios of neonatal thoracic surgery are reviewed including anaesthetic care during: (1) laryngoscopy and rigid bronchoscopy, (2) thoracoscopy, (3) repair of tracheo-oesophageal fistula, (4) resection of congenital cystic adenomatoid malformation, and (5) treatment of congenital lobar emphysema.

摘要

新生儿胸外科手术期间的麻醉护理融合了新生儿麻醉和胸科麻醉知识库的组成部分。本章回顾了新生儿胸外科手术期间的麻醉原则，包括术前评估、麻醉诱导技术、维持麻醉和术后镇痛的选择。此外，鉴于在这些手术过程中需要提供最佳的手术视野，可能需要进行单肺通气（OLV）。本文回顾了在新生儿中提供OLV的技术以及OLV期间的麻醉护理原则。最后，本文回顾了新生儿胸外科手术的具体情况，包括以下手术期间的麻醉护理：（1）喉镜检查和硬质支气管镜检查，（2）胸腔镜检查，（3）气管食管瘘修复术，（4）先天性囊性腺瘤样畸形切除术，以及（5）先天性大叶性肺气肿的治疗。