丙泊酚复合芬太尼麻醉在复杂桡骨远端骨折手法复位中的应用  

Application of propofol combined with fentanyl anesthesia in manual reduction of complex distal radius fractures

作　　者：孙静涛[1] 平措郎加 嘎松郎加 其美仁真 Sun Jingtao;Pingcuo Langjia;Gasong Langjia;Qimei Renzhen(Tianjin Fourth Central Hospital,Tianjin 300140,China;Changdu Tibetan Hospital,Changdu 854000,China)

机构地区：[1]天津市第四中心医院,300140 [2]西藏自治区昌都市藏医院,854000

出　　处：《中国实用医刊》2020年第2期22-24,共3页Chinese Journal of Practical Medicine

基　　金：西藏自治区藏医药管理局局级科研课题(JJKT2018011)。

摘　　要：目的探讨丙泊酚复合芬太尼麻醉在复杂桡骨远端骨折手法复位中的应用效果。方法随机抽取2015年3月至2017年12月急诊接诊复杂桡骨远端闭合骨折患者32例,男21例,女11例,年龄36~54岁。所有患者术前禁食4~6 h,禁水2~4 h,麻醉前均建立静脉通路,给予心电监护监测各项生命体征,面罩吸氧。先予以芬太尼0.05 mg/kg静脉注射,之后静脉推注丙泊酚1.5~2.0 mg/kg,注射速度4 mg/s。观察其麻醉效果。结果32例患者均一次麻醉复位成功,麻醉过程平稳、麻醉满意后呼吸频率减慢的发生率为62.5%,血氧饱和度下降发生率为65.6%,但所有患者均在5 min内自行恢复。结论丙泊酚复合小剂量芬太尼用于复杂桡骨远端骨折手法复位简便易行,诱导迅速舒适,苏醒快而完全,但应注意其对呼吸、循环功能的抑制作用。Objective To investigate the effect of propofol combined with fentanyl anesthesia on manual reduction of complex distal radius fractures.Methods A total of 32 patients with complicated distal radius fractures from March 2015 to December 2017 were selected. There were 21 males and 11 females, aged 36-54 years. All patients were fasted for 4-6 h, and 2 to 4 h forbidden before operation. Venous pathways were established for all patients before anesthesia. Electrocardio monitoring was performed to monitor vital signs, and oxygen masks were used for all patients. The fentanyl was administered intravenously at 0.05 mg/kg, followed by intravenous bolus of 1.5 to 2.0 mg/kg, injection rate of 4 mg/s. Their anesthetic effects were observed.Results All the 32 patients were successfully anesthetized, and the anesthesia was stable. The rate of respiratory rate slowdown was 62.5%, and the incidence of oxygen saturation reduction was 65.6%. But all patients recovered on their own within 5 minutes.Conclusions Propofol combined with low-dose fentanyl is a simple and easy method for manual reduction of complex distal radius fractures. It can induce rapid and comfortable recovery, but its inhibition on respiratory and circulatory functions should be paid attention to.

关 键 词：丙泊酚 芬太尼 复杂桡骨远端骨折 静脉麻醉 

分 类 号：R614[医药卫生—麻醉学]