瑞芬太尼复合丙泊酚在髋关节脱位手法复位术中的应用

Application of remifentanil combined with propofol in anesthesia of manual reduction to dislocation of the coax

目的探讨瑞芬太尼,芬太尼复合丙泊芬在髋关节脱位手法复位术中的临床效果。方法62例行髋关节脱位手法复位术的患者(ASAⅠ-Ⅱ级),随机分为瑞芬太尼(R)组,芬太尼(F)组,R组静脉注射瑞芬太尼1μg/kg+丙泊酚1mg/kg。F组静脉注射芬太尼1μg/kg+丙泊酚1mg/kg,观察SBP,DBP,HR,RR,SpO2的变化,记录诱导时间,苏醒时间,手术时间,丙泊酚总量,呼吸抑制发生率,麻黄素阿托品用量,恶心呕吐发生率,患者和手术医生满意度等指标。结果两组诱导时间相似,R组苏醒时间较F组短,两组丙泊酚总量相似,R组呼吸抑制较F组发生率高,两组用药后SBP,DBP,MAP,HR,SpO2均较用药前下降。恶心呕吐发生率,患者和手术医生满意度两组相似。结论瑞芬太尼复合丙泊酚用于髋关节脱位手法复位术苏醒较芬太尼复合丙泊酚快,但呼吸抑制较明显,应加强呼吸的管理。

Objective To investigate clinical effect of remifentanil and fentanyl combind with propofol in the manual reduction to dislocation of the coax. Methods 62 ASA Ⅰ-Ⅱ patients undergoing manual reduction to dislocation of the coax were randomly divided into two groups. The patients in group R received remifentanil combined with propofol. The group F received fentany injection combined with propofol. The onset time,recovery time,operation time,respiratory depression scale, total dosage of the propofol,SBP, DBP, HR, SpO2 at different time points during operation, side effects after operation,satisfaction of patients and surgeons were recorded. Results Compared to the preoperative, SBP, DBP, HR, SpO2 were lower during operation. The recovery time in group R was shorter than in group F. The respiratory suppression was greater in group R than in group F. Conclusion In anesthesia of manual reduction to dislocation of the coax, the recovery time in remifentanil combined with propofol is shorter than that in fentanly, but more attention should be paid to the respiratory depression of remifentanil.