小儿上呼吸道感染的麻醉处理

Satoshi Toyama
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引用次数: 0

摘要

呼吸不良事件,如咳嗽、缺氧、喉痉挛、支气管痉挛和喘鸣,是小儿麻醉期间发病率和死亡率的主要原因。由于多项研究表明上呼吸道感染是围手术期呼吸道不良事件的独立危险因素,因此有上呼吸道感染的患儿择期手术时需要仔细评估以决定是否继续麻醉。然而,并没有关于继续或推迟麻醉的标准指南,因此决策过程通常基于独特的机构、患者、手术和社会因素。大多数围手术期呼吸系统不良事件是可以预测、识别和治疗的,而喉痉挛和支气管痉挛可导致氧饱和度过低和死亡,是严重的并发症,其预防和治疗具有挑战性。麻醉医师应熟悉围手术期呼吸系统不良事件的预防和处理。
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[Anesthetic Management of Children with Upper Respiratory Tract Infections].

Respiratory adverse events, such as cough, hypoxia, laryngospasm, bronchospasm and stridor, are major causes of morbidity and mortality during pediatric anesthesia. Since several studies have shown that upper respiratory tract infection is an independent risk factor for perioperative respiratory adverse events, children presenting for elective surgery with upper respiratory tract infection require a careful evaluation to decide whether or not to proceed with anesthesia. However, there are no standard guidelines to proceed with or postpone anesthesia, and thus the decision pro- cess is often based on unique institutional, patient, surgical, and social factors. Most of perioperative respira- tory adverse events can be anticipated, recognized, and treated easily, while laryngospasm and bronchospasm that can lead to oxygen desaturation and death are serious complications and their prevention and treat- ment are challenging. Anesthesiologists should be fa- miliarized with the prevention and treatment of peri- operative respiratory adverse events.

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