庞塞蒂法治疗马蹄内翻足跟腱切断术的镇静方案
Sedation protocols for Ponseti clubfoot Achilles tenotomy.
作者信息
Bor Noam, Katz Yeshayahu, Vofsi Oded, Herzenberg John E, Zuckerberg Aaron L
机构信息
Pediatric Orthopedic Unit, HaEmek Medical Center, Afula, 18101, Israel.
出版信息
J Child Orthop. 2007 Dec;1(6):333-5. doi: 10.1007/s11832-007-0059-8. Epub 2007 Nov 3.
PURPOSE
Ponseti clubfoot management requires percutaneous tenotomy in 90% of cases, typically with local anesthesia. We report two light sedation protocols for outpatient tenotomy.
METHODS
Operating room protocol: 24 patients (36 club feet; mean age at tenotomy, 70 days) underwent mask induction with oxygen/nitrous oxide. Pediatric intensive care unit protocol: five patients (eight club feet; mean age at tenotomy, 119 days) underwent intravenous propofol infusion with supplemental oxygen.
RESULTS
All patients were discharged several hours after surgery with no complications. Anesthesia that is administered intravenously might have less risk of bronchial reaction than anesthesia that is administered by inhalation.
CONCLUSIONS
Our light sedation protocols offer safe alternatives to general anesthesia. Disadvantages include increased cost when compared with local anesthesia. Light sedation can be used effectively and has advantages when treating older infants who might struggle while under local anesthesia.
目的
庞塞蒂法治疗马蹄内翻足在90%的病例中需要经皮跟腱切断术，通常采用局部麻醉。我们报告两种用于门诊跟腱切断术的轻度镇静方案。
方法
手术室方案：24例患者（36只马蹄内翻足；跟腱切断术平均年龄70天）接受氧气/氧化亚氮面罩诱导。儿科重症监护病房方案：5例患者（8只马蹄内翻足；跟腱切断术平均年龄119天）接受静脉注射丙泊酚并补充氧气。
结果
所有患者术后数小时出院，无并发症。静脉给药麻醉可能比吸入给药麻醉发生支气管反应的风险更低。
结论
我们的轻度镇静方案为全身麻醉提供了安全的替代方案。缺点包括与局部麻醉相比费用增加。轻度镇静可有效使用，在治疗局部麻醉时可能挣扎的大龄婴儿时有优势。
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