异丙酚在急性髋关节脱位中医手法复位中的临床应用

Clinical Application of Propofol on Acute Dislocation of the Hip of Chinese Medicine Close Manipulative Reduction

目的:观察异丙酚在急性髋关节脱位中医闭合手法复位中的麻醉效果.方法:选择闭合性髋关节脱位患者40例,术前常现禁饮禁食。入室后,开放静脉通路,常规监测呼吸、血压、脉搏和血氧饱和度(SpO2),面罩吸氧,静脉注射丙泊酚1.5~2.5mg/kg,40~60s注完,睫毛反射消失后开始复位术,观察呼吸、循环变化及苏醒时间。结果:所有患者均一次手法复位成功,手术时间15s^4min。麻醉诱导平稳,对呼吸、循环有轻度影响,复位过程中,SpO2均有不同程度下降,有11例患者小于90%,面罩吸氧后即恢复。血压、心率较麻醉前减低,发生率分别为40.3%和75.3%,病人肌肉松弛,无体动及呕吐。苏醒时间为(7±2)min,醒后偶有恶心、头昏、头痛等发生。结论:异丙酚麻醉用于关节脱位后中医闭合手法复位,麻醉效果确切,操作简便,诱导快,苏醒迅速而完全,无需病人变动体位,是一种安全有效的无痛复位麻醉方法,值得临床推广。

Objective： To observe the anesthesia effect of propofol on acute dislocation of the hip in the efficacy of Chinese medicine close manipulative reduction. Methods： Closed dislocation of the hip choice of 40 patients, and are forbidden to drink in Preoperative. While entering the operating room ,open venous and monitoring breathe,blood pressure, pulse rate , oxygen saturation （SpO2）, breathe oxygen by mask. By intravenous injection of propofol 1.5mg - 2.5 mg/kg,in 40 seconds to 60 seconds. To reposition when loss of eyelash reflex . At the same time to observed breathing cycle changes and recovery time. Results： All patients had a successful reduction practices, the operation time from 4 minutes to 15 seconds. Smooth induction of anesthesia, the breathing and cycle mild, on reduction process, SpO2 have different levels drop 11 patients with less than 90% ,but reture qickly on breathe oxygen by masks. Blood pressure and heart rate lower than pre - anesthesia, the rates were 40.3% and 75.3%, and muscle relaxation,have no action and vomiting. Recovery time was （7± 2 ） minutes . After awakening nausea, dizziness, headaches occur occasional. Conclusion： Chinese closure means treating dislocation reduction by propofol anesthesia, anesthesia precise, simple, rapid induction, rapid and complete recovery, the patient is no need to change position. Narcotic pain reduction is a safe and effective. The method is useful clinical.