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lin06900 · Wysłany: Czw 15:01, 24 Mar 2011

Cleft palate surgery in children after tracheal extubation clinical analysis of hypoxemia

No visible signs of hypoxia,[link widoczny dla zalogowanych], such as the lips, nail bed, peripheral changes in skin color ... if were not in time,[link widoczny dla zalogowanych], there may be cardiac arrest. Therefore, how to detect and deal with Pat arouse people's attention. When the oxygen pulse, blood pressure and a tL, electrogram changes occur later, often can not rely solely on routine monitoring of these 57 * mill porridge hypoxia forecast Volume 7 of November 1997 ll smoke a vd7 № 1INov. 1997,[link widoczny dla zalogowanych], early indicators of _2J,[link widoczny dla zalogowanych], which can quickly and accurately monitor sPO2 reflect hypoxia, arterial oxygen saturation with good correlation _3J, take this to reflect the respiratory,[link widoczny dla zalogowanych], circulatory changes, will help improve the security of post-extubation . It is this group perceived to 1,3,5,7 min after extubation when compared with those before anesthesia SPO2 decreased significantly <O. 01), after extubation 1,3 minSPO2 a transient drop in comparison with the drop off significantly when q5min (P <0.o1), these results suggest that the first 7min after extubation prone sPO2 decline is generally believed that the following factors may be For: cleft palate repair surgery, pharyngeal anatomical changes employment so that the narrow pharynx, causing upper respiratory tract is not smooth; preoperative disinfectant used in mouth tissue irritation caused by allergic reactions and continuous intraoperative spatula base of the tongue caused by venous compression and lymphatic flow disorders are swelling of the tongue body, causing poor ventilation; surgery in the suction side of the throat plane bleeding, exudate and secretions are also easy to cause SPO2 decreased. This is due to extubation anesthesia is lighter, more sensitive suction tube to stimulate the pharynx, there may be nausea, breath-hold and other adverse reactions, resulting in decreased sPO2; suction tube before extubation when the tracheal tube inserted, the direct impact on ventilation such as the deep trachea. The stimulation can cause choking. Some or even bronchospasm. On the other hand some of the sick child after extubation because of the tongue or throat spasms fall, so obviously inadequate ventilation and oxygen consumption caused by the strong increase of the reaction and the children themselves to a high metabolic rate and oxygen consumption caused a large decrease sPO2; anesthesia drugs, muscle relaxants, and the residual effect of adjuvant drugs to genioglossus, soft palate, epiglottis and pharyngeal wall tissue relaxation of tight gas into the block, while more than a central inhibition anesthetics, such as after the sick child in the not yet fully awake state extubation, not only affects the airway open, but also because of the lack of respiratory center, such as excitatory response 【q and less sensitive to lung ventilation can reduce, or even result in decreased sPO2 after extubation; merger enlarged tonsils who cleft palate children have different levels of habitual tongue reduction, combined Ⅱ 'more swollen tonsils, upper respiratory tract can lead to poor; intubation laryngeal edema caused by improper operation. Vijaykllma other _4 50% occurrence of inhalation anesthesia: 50% of the oxygen and air mixtures, the high incidence of hypoxemia, and inhalation of pure oxygen are greatly reduced its incidence. Similar to that observed in this group. Therefore, cleft palate should be careful to take good time to extubation. Avoid premature extubation, after extubation is best to use pure oxygen mask sucked up more than 10min to ensure the body's demand for oxygen. When necessary, the built-release oral or oropharyngeal ventilation tube fixed tongue with thick thread will be under the tongue out of the estuary and the supporting measures can lead to separation of the tongue base and posterior pharyngeal wall to avoid upper airway obstruction and hypoxemia .
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