瑞芬太尼复合丙泊酚麻醉在肩关节脱位复位中的应用

【摘要】 目的:评价瑞芬太尼复合丙泊酚麻醉在肩关节脱位手法复位中的麻醉效果。方法:ASA Ⅰ～Ⅱ级肩关节脱位手法复位病人60例,随机分为常规臂丛麻醉组（Ⅰ组）、芬太尼复合丙泊酚组（Ⅱ组）和瑞芬太尼复合丙泊酚组（Ⅲ组）,每组20例,观察并记录麻醉前3分钟、麻醉后1分钟、复位时、复位后3分钟的SBP、DBP、HR、SP0₂,记录术毕停药后病人呼之睁眼的时间,记录复位时疼痛视觉模拟评分（VAS）,记录手术医生满意度。结果:Ⅰ组、Ⅱ组、Ⅲ组病人用药后SBP、DBP、HR、SP0₂均有变化（P<0.05）,但Ⅲ组变化轻（P<0,05）;Ⅲ组术后呼之睁眼的时间明显短于Ⅱ组（P<0.05）;Ⅱ组、Ⅲ组VAS和医生满意度明显高于Ⅰ组（P<0.05）。结论:瑞芬太尼复合丙泊酚全凭静脉麻醉可安全、有效地应用于肩关节脱位手法复位中。更多还原

【Abstract】 Objective :To evaluate the effect of Remifentanil combined with Propofol in totally intravenous anesthesia to shoulder reduction for dislocation of shoulder joint. Methods:Total 60 patients with ASA Ⅰ ～ Ⅱ were divided into 3 groups randomly, there were 20 cases every group: group Ⅰ （ brachial plexus anesthesia）, group Ⅱ （ Intravenous fentanyl combined with propofol ）, group Ⅲ （Intravenous remifentanil combined with propofol）.SBP, DBP, HR and SPO₂ were observed and recorded at the time 3 minutes prior to the anesthesia, 1 minute after the anesthesia,time of reduction and time of 3rd minute after reduction respectively.The time of eyes open was recorded after operation, VAS was recorded in reduction and surgeon s satisfactions were also recorded.Result: SBP, DBP, HR and SPO₂ changed in group Ⅰ , group Ⅱ and group Ⅲ （ P < 0.05 ）, but group Ⅲ changed slightly （ P < 0.05 ）.The time of eyes open in group Ⅲ were signifi- cantly shorter than group Ⅱ （ P < 0.05 ） ; VAS and surgeon ’s satisfactions in group Ⅱ and group Ⅲ were significantly better than group Ⅰ （ P < 0.05）.Conclusion : The application of Remifentanil Combined with Propofol in Totally Intravenous Anesthesia in shoulder reduction for Dislocation of Shoulder Joint is safe and effective.更多还原