| Objective:To compare the effect of ultra-fast track anesthesia and traditional anesthesia management methods on serum high sensitivity C-reactive protein (HsCRP), C-reactive protein (CRP) and procalcitonin (PCT) during pediatric cardiac perioperative.Methods:From September 2013 to May 2014, the data of 101 children underwent cardiac surgery anesthesia by the same anesthesiologist were reviewed. According to the standard,40 chidren were enrolled in ultra-fast track anesthesia group (group F),44 children in traditional anesthesia group (group C). HsCRP, CRP and PCT levels on preoperation(T0),the first day(T1),the second day(T2) post operation were compared between two group.Results:1.HsCRP content:in group F HsCR content increased gradually, comparison among T0, T1 and T2 had significant difference (0.39±0.66vs13.15±1.07vs13.86±0.93, P<0.01); In group C,HsCR content also increased gradually, comparison among T0, T1 and T2 have significant difference (0.44±0.46vs13.56±0.97vs14.30±0.78, P<0.01); Compared HsCRP levels in T1 between two groups, group F were significantly lower than group C (13.15±1.07vs13.56±0.97, P<0.05)2. CRP levels:comparison between T1 and T2 in group F, CRP levels had no statistical difference; CRP levels increased gradually in the group C, there are significant differences between T1 and T2 ((35.85±21.84 vs74.96±39, P<0.01). Compared the two groups On T2, CRP content in group C was significantly higher than that of group F (42.81±32.63vs74.96±39.32, P<0.01)3. PCT levels:Compared each point in the two groups, PTC content has no obvious change. Compared the two groups on T1, PCT levels in group C were significantly higher than that of group F (5.56±6.77vs1.56±1.41, P<0.01)Conclusion:Compared with the traditional anesthesia,the effects of ultra-fast track anesthesia on high-sensitivity C-reactive protein, C-reactive protein and procalcitonin were difference, it might reduce the occurrence of ventilator associated pneumonia which related delaying extubition.Objective:To evaluate the feasibility and safety of the application of laryngeal mask airway(LMA) combined with ultra-fast track anesthesia to the congenital heart surgery in children with airway stenosis.Methods:From January 2013 to January 2015, sixteen pediatric patients were enrolled in accordance with the criteria. All patients inserted LMA were adopted combined intravenous and inhalation anesthesia for cardiac operation with extracorporeal bypass(CPB). Perioperative data were collected. The results of blood gas were recorded at 5min after insertion of LMA (T1),10min after CPB stop (T2)and 5min after removal of LMA(T3). Airway pressure after insertion of LMA and heart rate changes during TEE check were observed.Results:1.These cases included ventricular septal defect in 9 patients, atrial septal defect in 1 patient, ventricular septal defect combine with atrial septal defect in 2 patients, triatrial heart combine with atrial septal defect in 1 patient, partial anomalous pulmonary venous drainage in 1 patient and Tetralogy of Fallot in 2 patient.5 cases were confirmed tracheal stenosis by computed tomography before operation and 11 cases were encountered when intubated.2. Laryngopharyngeal injury was not found. No intubation was need after operation. No obvious heart rate change were observed during TEE check.3. Compared with T1, pH decreased at T3 (7.35±0.05vs7.42±0.05, P<0.05), the difference was statistically significant; PCO2 increased at T2 and T3 (36±5vs31.38±5.09, P<0.05; 40±6vs31.38±5.09,p<0.05), the difference was statistically significant; Lactic acid increased at T2 (1.05±0.37vs0.76±0.24, P<0.05), the difference was statistically significant.Conclusion:It is safe to apply laryngeal mask airway combined with ultra-fast track anesthesia to the congenial heart surgery of child with tracheal stenosis. |
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