Winch Peter D, Stevens William
Department of Anesthesiology, Nationwide Children's Hospital and The Ohio State University, Columbus, Ohio, USA.
Ann Thorac Surg. 2009 Aug;88(2):654-6. doi: 10.1016/j.athoracsur.2008.12.064.
Although the risks and benefits of regional anesthesia for thoracic surgery are documented, little has been written about using such techniques in pediatric patients undergoing organ transplantation on cardiopulmonary bypass. The placement of thoracic epidurals in unconscious patients, the use of catheters in patients requiring heparinization, and indwelling catheters in immunosuppressed patients are topics of perennial debate. This report describes a thoracic epidural facilitated by intravenous dexmedetomidine in the management of a child who underwent bilateral lung transplantation. Using dexmedetomidine for postoperative sedation may increase the feasibility of regional techniques in patients at increased risk of associated complications.
虽然区域麻醉用于胸外科手术的风险和益处已有文献记载，但关于在接受体外循环器官移植的儿科患者中使用此类技术的报道却很少。在无意识患者中放置胸段硬膜外导管、在需要肝素化的患者中使用导管以及在免疫抑制患者中留置导管一直是长期争论的话题。本报告描述了在一名接受双侧肺移植的儿童的管理中，静脉注射右美托咪定辅助胸段硬膜外麻醉的情况。使用右美托咪定进行术后镇静可能会增加在发生相关并发症风险较高的患者中应用区域技术的可行性。
