Extubation During Ultrafast Track Anesthesia Of Congenital Heart Surgery

The Influence of Aminophylline on Ultrafast Track Anesthesia Extubation After Congenital Heart SurgeryObjective We investigated the effects of aminophylline on ultrafast track anesthesia on children undergoing congenital heart surgery.Methods Ninety children with simple congenital heart diseases(CHD)undergoing selective operations were randomly divided into three groups:at the end of the surgery,group ? received 3ml normal saline,group ? received 1 mg/kg aminophylline,group ?received 2 mg/kg aminophylline.Extubation in operating room,BIS values,related respiratory parameters,hemodynamic parameters and serum aminophylline concentrations were recorded.Results The successful extubation rate was higher in group ?,? than group ?(P<0.05),BIS values were increased in group ?,? when compared with group ? at 9 minutes(P<0.05),the respiratory rate at extubation was higher in group ?,? than group ?(P<0.05),but within clinically acceptable range.There was no significant difference between group ? and group ?.No differences in the time of spontaneous breathing recovery,pH value at extubation,mean blood pressure,heart rate,the incidence of adverse events,the length of ICU stay and the length of hospital stay after surgery between groups were found.Conclusion Aminophylline 1?2 mg/kg can increase successful extubation rate in operating room after congenital heart surgery,shorten recovery time and increase respiratory rate,thus improve the safety of the ultrafast track anesthesia.The Application of Different Extubation Strategy of Ultrafast Track Anesthesia on Simple Congenital Heart Disease Children with Open Heart SurgeryObjective Hypercapnia and aminophylline can shorten emergence time from anesthesia in adult.However,the pathophysiology of children with congenital heart disease is different from that of adult patients.We investigated the application of different extubation strategies(customary extubation,hypercapnia extubation and aminophylline extubation)in ultrafast track anesthesia of open heart surgery for pediatric simple congenital heart disease patients.Methods We selected 90 children undergoing selective corrective operations of simple congenital heart diseases,these patients were randomly divided into three groups:PetCO2 at the end of the surgery in group ? and group ? were maintained between 35mmHg and 45mmHg,but was elevated to 45-55 mmHg via adjusting tidal volume when the sternum was begin to be closed in group ?.At the end of the surgery group ? and group ? received 3ml normal saline,while group ? received ? mg/kg aminophylline diluted to 3ml.Operating room extubation,BIS values,related respiratory parameters and hemodynamic Parameters,the length of ICU stay and the length of hospital stay were recorded.Results The time of spontaneous breathing recovery was shorter in group ?,? than in group I(P<0.05),the respiratory rate at extubation was higher in group ?,? than in group I(P<0.05),the maximal PetCO2 during extubation was higher in group ?,? than that in group II(P<0.05),the successful extubation rate was higher in group ?,? than in group I(P<0.05).There was no significant difference between group ? and group ?.No significant differences of mean blood pressure,heart rate,BIS,the incidence of adverse events,the length of ICU stay and the length of hospital stay in different groups.Conclusion Aminophylline 1 mg/kg can decrease the CO2 threshold of excitatory respiratory center and shorten spontaneous breath recovery time in a non-carbon dioxide retention manner,thus the safety of the ultrafast track anesthesia was improved.