Department of Anesthesiology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, Guangdong510623, China.
Cardiol Young. 2022 Jul;32(7):1092-1097. doi: 10.1017/S1047951121003681. Epub 2021 Sep 8.
The usefulness of ultra-fast track cardiac anaesthesia may give great benefits to patients; however, its usefulness has not been completely evaluated in infants and toddlers, who are generally considered the most difficult group for ultra-fast track cardiac anaesthesia.
A total of 130 children were allocated randomly into to a ultra-fast track cardiac anaesthesia group (Group D) or a conventional anaesthesia group (Group C) (each n = 65). In Group D, dexmedetomidine was administrated at a dosage of 1 µg/kg/hour after induction. The patient- controlled intravenous analgesia was dexmedetomidine and sufentanil. In Group C, patients were infused with of the same volume of normal saline, and sufentanil alone for patient-controlled intravenous analgesia. The dosages of sufentanil, extubation time, haemodynamic parameters, postoperative hospitalisation conditions, pain and sedation scores, blood gas analysis, and inotropic scores were all recorded.
The dosage of sufentanil (1.49 ± 0.05 vs. 3.81 ± 0.04 µg, p < 0.001) and extubation time (2.63 ± 0.52 vs. 436.60 ± 22.19 minutes, p < 0.001) in Group D were all significantly lower than those in Group C. Moreover, cardiac intensive care unit stay time, total hospital stay, hospitalisation costs, postoperative lactate levels, and inotropic scores were also significantly lower in Group D.
Using of ultra-fast track cardiac anaesthesia in infants and toddlers is effective, it not only reduce the perioperative requirement for opioids and shorten the extubation time but also decreases the inotrope requirement and provide a better postoperative condition for young children.
超快通道心脏麻醉可能会为患者带来巨大益处；然而，它在婴儿和幼儿中的有效性尚未得到充分评估，这些儿童通常被认为是最难以进行超快通道心脏麻醉的群体。
将 130 名儿童随机分为超快通道心脏麻醉组（D 组，n = 65）或常规麻醉组（C 组，n = 65）。在 D 组中，在诱导后以 1 µg/kg/h 的剂量给予右美托咪定。患者自控静脉镇痛采用右美托咪定和舒芬太尼。在 C 组中，患者输注相同体积的生理盐水，舒芬太尼单独用于患者自控静脉镇痛。记录舒芬太尼用量、拔管时间、血流动力学参数、术后住院情况、疼痛和镇静评分、血气分析和正性肌力评分。
D 组舒芬太尼用量（1.49 ± 0.05 比 3.81 ± 0.04 µg，p < 0.001）和拔管时间（2.63 ± 0.52 比 436.60 ± 22.19 分钟，p < 0.001）均显著低于 C 组。此外，D 组心脏重症监护病房停留时间、总住院时间、住院费用、术后乳酸水平和正性肌力评分也显著降低。
在婴儿和幼儿中使用超快通道心脏麻醉是有效的，它不仅减少了围手术期对阿片类药物的需求并缩短了拔管时间，还降低了正性肌力药物的需求，并为幼儿提供了更好的术后状态。
