Breschan C, Likar R
Abteilung für Anästhesiologie, LKH, St. Veiterstrasse 47, 9020, Klagenfurt, Osterreich.
Anaesthesist. 2006 Oct;55(10):1087-98. doi: 10.1007/s00101-006-1058-8.
The physiology of the preterm and term neonate is characterized by a high metabolic rate, limited pulmonary, cardiac and thermoregulatory reserve and decreased renal function. Multisystem immaturity creates important developmental differences in drug administration and response when compared to older children. Specific monitoring techniques are required because the neonate is not physically accessible to the anesthetist during the operation. This contribution reviews the specific pathophysiological characteristics of the newborn with relevance to anesthesia and also provides robust guidelines for the anesthetic management of the most frequent non-cardiac procedures which need surgery during the neonatal period. Consideration will also be given to the anesthetic management of very low birth-weight infants with anesthetic key issues such as avoiding hyperoxia, keeping hemodynamic parameters as stable as possible and preventing hypothermia.
早产儿和足月儿的生理特点是代谢率高、肺、心脏和体温调节储备有限以及肾功能下降。与大龄儿童相比，多系统不成熟在药物给药和反应方面造成了重要的发育差异。由于在手术过程中麻醉医生无法直接接触新生儿，因此需要特定的监测技术。本文综述了与麻醉相关的新生儿特定病理生理特征，并为新生儿期最常见的非心脏手术的麻醉管理提供了有力的指导方针。还将考虑极低出生体重儿的麻醉管理，以及避免高氧、尽可能保持血流动力学参数稳定和预防体温过低等麻醉关键问题。
