Anesthesia Management Of Baby Congenital Hypertrophic Pyloric Stenosis

ObjectiveTo observe congenital hypertrophic pyloric stenosis neonatal intubation andthe intubation of general anesthesia efficacy and safety, to provide theoreticalbasis for clinical application.MethodCongenital hypertrophic pyloric stenosis baby and cases. Cases, agedbetween1-3months. Are divided into two big groups, ketamine group (K group)and intubation group (group E), K group of intubation anesthesia group (T1)induced by intravenous push note midazolam0.06mg/kg, ketamine2mg/kg, thesurgeon for disinfection, operation cut skin (T2) before additional ketamine dosefor [T2-T1(min)/15]1mg/kg, later every15min additional ketamine1mg/kg,when necessary, suction sevoflurane maintain, preoperative acid-baseimbalances are divided into normal group for K1, K2group; for middel E groupfor intubation group anesthesia induction using midazolam0.06mg/kg, fentanyl5ug/kg, rocuronium injection1mg/kg in turn push note intravenous induction,2min after endotracheal intubation after breathing machine mechanicalventilation, preoperative acid-base imbalances are divided into normal for E1group, was abnormal for E2group. Monitoring anesthesia induction (T1),operation cut skin (T2), the operating room (T3) at MAP, HR, ECG, SpO2,breathe out the carbon dioxide. Observation intraoperative secretion,intraoperative and postoperative fidgety breathless number number behaviorindicator; Monitoring anesthesia induction (T1) and the operating room (T3) atthe flesh.Results1. The general situationFour group patients between demographic dataset is compared between differences were no statistical significance (P>0.05), see table1.2.Physiology indexMonitoring anesthesia induction (T1), operation cut skin (T2), the operatingroom (T3) time physiological indicators:2.1cycle indexFour subgroups T1, T2time between MAP and HR no statistical difference,T3moment K2group is higher than any other group of sanya MAP, HR are low,the difference was statistically significant (P <0.05); There is no abnormal ECGappeared.2.2breathing indexFour subgroups T2SpO2between T1, there was no significant differencebetween groups, T3K2group time than other sanya SpO2group are low, thedifference was statistically significant (P <0.05).Four subgroups T1, T2breath between the carbon dioxide no statisticallysignificant differences, T3K2group time than other sanya group at the end of thebreath of carbon dioxide are high, the difference was statistically significant (P<0.05).Intraoperative appear respiratory depression, need to deal with K2groupthan other sanya group are high, the difference was statistically significant (P <0.05).3.ChangePH changeWhen the T1PH K2group, E2group a K1group, E1group is high, there isstatistical significance, T3PH K2group when a K1group, E1group, E2group ishigh, the difference was statistically significant (P <0.05).PaCO2When the T1PaCO2K2group, E2group a K1group, E1group is high, thereis statistical significance, T3PaCO2K2group when a K1group, E1group, E2group is high, the difference was statistically significant (P <0.05).BE changeWhen the T1BE K2group, E2group a K1group, E1group is high, there isstatistical significance, T3BE K2group when a K1group, E1group, E2group ishigh, the difference was statistically significant (P <0.05).K+change When the T1K+K2group, E2group a K1group, E1group is low, havestatistical significance, T3K+K2group when a K1group, E1group, E2group islow, the difference was statistically significant (P <0.05).4.Behavior indexPostoperative fidgety K2group than the other three and is comparedbetween qol (P <0.05), and other groups of sanya, the differences were nostatistical significance (P>0.05).ConclusionCongenital hypertrophic pyloric stenosis anesthesia choice generalanesthesia and general anesthesia intubation was higher than general anesthesiaintubation more safety. The acid-base imbalances person, choose intubationgeneral anesthesia and general anesthesia are not intubation, But with theacid-base imbalances, and general anesthesia more safety.