静脉快通道麻醉在骨关节脱位复位术中的应用  

Intravenous anesthesia in the fast-track bone dislocation reduction surgery

作　　者：侯铁军 陈继恩 孙建国 

机构地区：[1]东莞市常平人民医院麻醉科,广东东莞523573

出　　处：《中国医疗前沿》2009年第1期45-46,共2页China Healthcare Innovation

摘　　要：目的观察静脉快通道麻醉在骨关节脱位复位术中的应用效果.方法选择ASA分级为Ⅰ～Ⅱ级的单纯性肩关节、髋关节脱位78例患者随机分为两组:A组:利多卡因传统麻醉组,待麻醉作用完全消失后自行离院;B组:丙泊酚静脉快通道麻醉组,完全清醒后无须住院自行离院。两组病人麻醉前30min肌注苯巴比妥钠2mg·kg-1、阿托品0.01mg·kg-1,入室后先建立静脉通路,备好麻醉器械和药品,全程监护生命体征,面罩吸氧,监测并记录MAP、HR、SpO2,麻醉准备时间(病人开始麻醉至麻醉效果满意的时间)、手术时间、自行离院时间(手术结束至自行离院时间)、手法复位成功率及不良反应。结果麻醉准备时间、自行离院时间A组明显长于B组,术中MAP、HR、SpO2均较稳定,各类复位手法均在一个复位程序中完成,无1例术后并发症。结论静脉快通道麻醉用于门诊骨关节脱位的手法复位,是无须住院病人的安全、可行和便捷的麻醉方法。Objective To observe the fast-track anesthesia in the vein of bone dislocation reduction surgery results and effort. Methods Select 78 patients ASA grade for the class Ⅰ～Ⅱ simple shoulder joint and hip dislocation, and randomly divided them into two groups： Group A： Traditional lidocaine anesthesia group, leave the hospital once the narcotic effect disappeared; Group B： Propofol intravenous anesthesia fast-track group, needless for hospitalization after entirely clear from anesthesia.Two groups of patients need to be intramuscular injected with 2 mg.kg4 sodium Phenobarbital and 0.01 mg.kg^-1 atropine just 30min before anesthesia. When entered into the operating room, establish the intravenous access, make ready of narcotic drugs and equipment, whole process intensive care of vital signs, Oxygen breath masks, monitor and record the MAP, HR, SpO2, anesthesia time （period from the beginning of anesthesia till the patient satisfy with the narcotic effect）, surgery time, left hospital time, the success rate of the operation and adverse reactions. Results Group A＇s Anesthesia time and time of left hospital were significantly longer than the Group B＇s; The intraoperative MAP, HR, SpO2 were stable; All types of reduction work were completed in one procedure; No case of no post-operative has complications. Conclusion Intravenous Fast-track Anesthesia for the patient＇s bone dislocation reduction without hospitalization is the best way for saintravenous anesthesia, the fast-track, bone dislocation, the manual reductionintravenous anesthesia, the fast-track, bone dislocation, the manual reductionfety, practical and convenient method of anesthesia.

关 键 词：静脉麻醉 快通道 骨关节脱位 手法复位 

分 类 号：R684.7[医药卫生—骨科学] R614.24[医药卫生—外科学]