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上呼吸道梗阻,肺通气/血流失衡,肺内分流,是小儿全麻后低氧血症的主要原因。由于经皮脉率测氧计的临床应用日益推广,提供了小儿尤其对婴幼儿连续和无创伤监测动脉血氧饱和度的手段,得以观察小儿全麻后低氧血症的情况。作者选择97例ASA Ⅰ级,1个月～17岁的小儿,平均4.2岁。都施行简单的(疝、鼓膜切开、下肢矫形术等)选择性手术。 62例术前未用药,用氟烷或异氟醚、N_2O麻醉。35例术前或麻醉中用麻醉性镇痛药。全部中的33例在静注阿托品(0.02mg/kg),琥珀胆硷(1m/kg)以及面罩吸氧64次后口插管,用改良Mapleson重复呼吸装置,用或不用扶助或控制呼吸。用过非去极化肌松剂的小儿,术毕静注阿托品(0.03mg/kg)和新斯的明(0.07mg/kg)对抗。在停用N_2O后,待有足够的自主呼吸后,均吸入纯氧至少逾3分钟,
Upper respiratory tract obstruction, pulmonary ventilation / blood flow imbalance, pulmonary shunt, is the main reason for hypoxemia in children after general anesthesia. As the clinical application of percutaneous pulse oximetry is increasingly being promoted, it provides a means of monitoring arterial oxygen saturation in children, especially for infants and young children, both continuously and noninvasively to observe the hypoxemia after pediatric general anesthesia. The authors selected 97 ASA Ⅰ grade, 1 month to 17-year-old children, with an average of 4.2 years old. Are performed simple (hernia, tympanotomy, orthopedic surgery, etc.) selective surgery. Sixty-two patients were premedicated without anesthesia and anesthetized with halothane or isoflurane and N2O. 35 cases were anesthetized with narcotic analgesics before or during anesthesia. Thirty-three of the patients were intubated after intravenous atropine (0.02 mg / kg), succinylcholine (1 m / kg), and mask oxygen 64 times, resuscitated with Mapleson breathing apparatus, with or without assistance or controlled breathing. Non-depolarizing muscle relaxants in children, intraventricular anesthesia atropine (0.03mg / kg) and neostigmine (0.07mg / kg) confrontation. After deactivating N_2O, inhale pure oxygen for at least 3 minutes after enough spontaneous breathing,