A Retrospective Study Of The Application Of Fast-Track Anesthesia In Children Undergoing Cardiac Surgery

Objective:To analyze the application of fast-track anesthesia in children undergoing cardiac surgery in Fuwai hospital retrospectively. The medical data will be the foundation of clinical works in future.Methods:Clinical materials of children undergoing cardiac surgery in Fuwai hospital from Mar.2012to Aug.2012were retrospectively analyzed. Nine hundred and fifty-three children were divided into group F (fast-track anesthesia) and group NF (non-fast-track anesthesia). The children in group F were divided into group A (received cisatracurium besilate) and group R (received rocuronium bromide). The children in group F were divided into group D (duration of postoperation mechanical ventilation≤3hours) and group C (duration of postoperation mechanical ventilation>3hours). All data were analyzed statistically by SPSS19.0.Results:1Compared with group NF (30.6%), group F had a higher proportion (58.7%) of children older than one year (P=0.000). Compared with group NF (31.6%), group F had a higher proportion (63.6%) of children more than ten kilograms (P=0.000) Compared with group NF(27.0%), group F had a higher proportion (82.2%) of children with simple congenital heart disease (P=0.000)2Compared with group R(78±43.7minutes), the time interval between muscle relaxants withdrawal and the end of operation was shorter in group A (44±44.2minutes)(P=0.000). Compared with group R (17.9±7.72ug/kg), the dose of fentanyl was higher in group A (22.9±8.86ug/kg)(P=0.000). There was no significant difference about the duration of postoperation mechanical ventilation between the two groups.3In group F, the duration of postoperation mechanical ventilation had a negative linear correlation with weight, time interval between muscle relaxants withdrawal and the end of operation, and time interval between analgesic withdrawal and the end of operation. And the duration of postoperation mechanical ventilation had a positive linear correlation with dose of fentanyl and duration of operation. 4Compared with group C (3.59±0.915ten thousands yuan), The hospital charge in group D (3.33±0.618ten thousands yuan) was lower (P=0.000)Conclusions:1The application of fast-track anesthesia in cardiac surgery is more suitable for children with simple congenital heart disease who is older than one year or more than ten kilograms.2Compared with the children received rocuronium bromide, muscle relaxants withdrawal may later and the dose of fentanyl may higher in the children received cisatracurium besilate, without prolonging the duration of postoperation mechanical ventilation.3For the children in the application of fast-track anesthesia, correlative factors of the duration of postoperation mechanical ventilation include weight of children, time interval between analgesics or muscle relaxants withdrawal and the end of operation, dose of fentanyl, and duration of operation.4In children undergoing cardiac surgery, the application of ultra-fast-track anesthesia may shorten duration of ICU stay and reduce hospital charge further.