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Objective To observe the clinical effect of artificial ventilation combined continuous positive airway pressure(CPAP) with removal of tracheobronchial foreign bodies for children and to explore the possibility and security of the method. Methods 60 children with tracheobronchial foreign body, underwent total intravenous anesthesia ,were randomly divided into A group and B group. Each group had 30 cases. A group was given artificial ventilation with CPAP. The bronchofibroscope was connected to anesthesia machine with side hole after induction for 3 minutes,and high fresh gas flow(10 ～ 15L/min) was given to maintain continuous positive airway pressure. B group were given high frequency jet ventilation(HFJV) ,60 ～ 100 bpm. The mask ventilation was given in stand of bronchofibroscope when SpO2 ＜ 90% and until SpO2 improved. MAP, HR, ECG, SpO2, PaO2, PaCO2 were monitored and recorded at time points: T0 (entered operation room), T1 (beginning of bronchofibroscopy), T2 (5 min after bronchofibroscopy), T3 (10 min after bronchofibroscopy), T4 (end of operation). The side effects, the rate of fail to bronchofibroscopy and the rate of intubations after operation in two groups were observed and recorded. Results The HR of post-anesthesia in two groups significantly decreased than those at T0 (P ＜ 0.01), but no difference showed in HR between two groups(P ＞ 0.05). SpO2 and PaO2 of post-anesthesia in two groups significantly increased than those at T0 (P ＜0. 01) ,PaO2 at T1 ,T2 ,T3 in A group were significantly higher than those in B group(P ＜0.05). PaCO2 gradually increased after bronchofibroscopy in two groups ,and the values in A group was significantly lower than in B group(P ＜0.05 or 0. 01). There were no significant differences in the rates of fail to bronchofibroscopy and of intubations after operation between two groups, but the total number of B group was higher. Conclusion Artificial ventilation with CPAP for children with removal of tracheobronchial foreign bodies was safe and practical, and has a better controllability, a minor effect to respiratory function, deserve popularizing.
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Objective To investigate the effect of prophylaxis against respiratory and circulation depression caused by propofol during painless colonoscopy by intravenous doxpram with small dose.Methods 80 patients undergoing painless colonoscopy were randomly divided into the control group(A group) and the doxpram group(B group).All patients used propofol,and then used propofol after induction.In group B,doxpram was injected before anesthesia.The degree and incidence rate of respiratory and circulotion depression,the dose of propofol,the awake time,the examination time,the complication during anesthesia and awake were monitored.Results The SBP,DBP,SpO2,RR during anesthesia were obviously lower in group A than in group B(P
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0.05).ANH average artery pressed to descendobviously after hemodilution(P
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Objective To investigate the effect and clinical valve of target-controlled infusion of remifentanil for conscious intubation of patients under fibrobronchoscopy.Methods Forty patients were randomly divided into two groups(F and R),each group contained 20 cases.All of the patients were intubated on regional anaesthesia,as the first step,then the patients in F group were given fentanyl 2?g/kg by vein.In remifentanil target-controlled infusion group(R group),the patients were kept infusing remifentanil 2ng/ml.Results (1)Haemodynamics:in R group,SBP and HR kept steadily;In F group,while the two indices increased significantly.(2)Static pulmonary function:in R group,RR,VT deceased remarkablely.There were no difference between two groups in SpO_2 and P_ ET CO_2.(3)Tracheal intubating condition and Ramsay score in R group were better than in F group;Cardiovascular response in R group was lower.Conclusion Target-controlled infusion of remifentanil for conscious intubation can achieve excellent result,with less cardiovascular response.