丙泊酚复合舒芬太尼在骨关节脱位复位术中的应用

目的探讨丙泊酚复合舒芬太尼快通道麻醉在骨关节脱位复位术中的应用。方法选择58例ASAⅠ～Ⅱ级的单纯性肩关节、髋关节脱位行闭合手法复位术患者。术前禁食6 h,禁水2 h。常规监测BP、HR、RR、SPO2,面罩吸氧,静脉缓慢注射舒芬太尼0.3～0.4μg/kg,注射时间>2 min。5 min后,静注丙泊酚1.5～2.0 mg/kg。记录麻醉前、用药后1 min、用药后5 min、术毕3 min病人的SBP、DBP、HR、SPO2、RR。记录麻醉时间、病人的清醒时间、离院时间,恶心、呕吐、嗜睡等不良反应的发生情况。结果术中患者血压维持相对稳定,心率下降相对明显;有3例病人出现恶心,经注射止吐药物盐酸昂丹司琼注射液得到缓解。所有病例在麻醉时间、清醒时间及离院时间上,无统计学意义。结论舒芬太尼复合丙泊酚快通道麻醉在骨关节脱位复位术中的应用,快捷、安全、舒适,值得临床推广。

Application of Propofol Fentanyl Compound with Sufentanil in Bone and Joint Dislocation Surgery

Objective To investigate fast-track anesthesia with propofol and sufentanil in in diaplasis surgery.Methods 58 cases of ASA classⅠtoⅡ simple shoulder or hip dislocation patients underwent closed manipulative reduction surgery treatment.Absolute diet at preoperative 6h and water deprivation 2 h.To make routine monitoring of BP,HR,RR,SPO2,oxygen mask.Slow intravenous injection the sufentanil 0.3-0.4 μg/kg,the injection time is over 2.0 min.Intravenous injection of C propofol 1.5-2.0 mg/kg 5.0 min later.To Record SBP,DBP,and HR,SPO2,the RR before anesthesia,1 min after treatment,5 min after medication,3 min post-surgery.To record duration of anesthesia,awake time,the occurrence of discharge time and adverse reactions of nausea,vomiting,lethargy.Results Intraoperative blood pressure remained relatively stable and heart rate decline is relatively obvious.There are three cases of patients with nausea who were alleviated by the injection of ondansetron hydrochloride injection.All cases in the duration of anesthesia,awake time and discharge time was not significant.Conclusion The fast track of sufentanil and propofol anesthesia in Bone and joint dislocation surgery might be quick;safe;comfortable;and it is worthy of promotion.