儿童哮喘患者的围手术期处理的更新.docx

儿童哮喘患者的围手术期处理的更新PediatrRep.2012Apri1.2;4(2):e1.9.Pub1.ishedon1.ine2012Apri1.5.doi:10.4081/pr.2012.e1.9PMCID:P.IC3395977UpdateonperioperativemanagementofthechiIdwithasthmaFrancescoDones,GraziaEoresta,andVincenzoKussottoAuthorinformationArtic1.enotesCopyrightand1.icenseinformationGoto:AbstractAsthmarepresentsthe1.eadingcauseofmorbidityfromachronicdiseaseamongchi1.dren.Dea1.ingwiththisdiseaseduringtheperioperativeperiodofpediatricsurgica1.proceduresis,therefore,quiteco11unonfortheanesthesio1.ogistandotherProfessiona1.itiesinvo1.ved.Preoperativeassessmenthasakeyro1.eindetectingchi1.drenatincreasedriskofperioperativerespiratorycomp1.ications.Forchi1.drenwithoutanoptima1.contro1.ofsymptomsorwitharecentrespiratorytractinfectione1.ectivesurgeryshou1.dbepostponed,ifpossib1.e,aftertheoptimizationoftherapy.Accordingtoc1.inica1.setting,1.oco-regiona1.anesthesiarepresentsthedesirab1.eoptionsinceita1.1.owstoavoidairwayinstrumentation.Airwaymanagementgoa1.sarepreventingtheincreaseofairf1.owresistanceduringgenera1.anesthesiaa1.ongwithavoidingtriggersofbronchospasm.Whentheiruseispossib1.e,facemaskventi1.ationandIaringea1.maskareconsideredmorere1.iab1.ethantrachea1.intubationforchi1.drenwithasthma.Sevof1.uraneisthemostcommon1.yusedanestheticforinductionandmanteinance.Sa1.butamo1.seemstobeusefu1.inpreventingairf1.owresistanceriseafterendotrachea1.intubation.Mechanica1.ventiIationshou1.dbetai1.oredaccordingtopathophysio1.ogyofasthma:anadequateexpiratorytimeshou1.dbesettedinordertoavoidapositiveend-expiratorypressureduetoexpiratoryairf1.owobstruction.Painshou1dbepreventedandprompt1.ycontro1.1.edwitha1.oco-regiona1.anesthesiatechniquewhenitispossib1.e.Potentia1.a1.1.ergicreactionstodrugsor1.atexshou1.da1.waysbeconsideredduringthewho1.eperioperativeperiod.Creatingasereneatmosphereshou1.dbeadoptedasanimportantcomponentofinterventionsino.