行中医手法复位术肩关节脱位患者选择吸入七氟烷全身麻醉的优劣势分析

Analysis of Advantages and Disadvantages in Shoulder Joint Dislocation Patients Treated with Traditional Chinese Medicine Manipulation Choosing Inhaled Sevoflurane General Anesthesia

目的:探讨吸入七氟烷全身麻醉方式对行中医手法复位术肩关节脱位患者的优劣势。方法:将符合标准的62例患者按半随机法分为七氟烷组(A组)、利多卡因组(B组)和异丙酚组(C组)。A组20例患者使用吸入七氟烷全身麻醉,B组21例使用利多卡因臂丛阻滞麻醉,C组21例使用异丙酚静脉全身麻醉。记录患者的诱导时间和苏醒时间,监测患者生命体征和不良反应发生情况。以VAS评分法[3]评定复位时的镇痛效果,并以自制量表评定手术医师的满意度。结果:A、B、C3组的麻醉优良率分别为100.00%、76.20%、95.25%。A组与B组比较,差异有统计学意义(P<0.05)。A组与C组比较,差异无统计学意义(P>0.05)。A组与C组麻醉诱导时间、患者疼痛程度评分和医师手法复位成功时间比较,差异均无统计学意义(P>0.05);麻醉苏醒时间、手术医师满意度比较,差异均有统计学意义(P<0.05)。A组与B组比较,患者疼痛程度评分、医师手法复位成功时间和手术医师满意度比较,差异均有统计学意义(P<0.05)。3组患者在麻醉过程中及治疗结束后均未见明显不良反应。结论:对施行中医手法复位术的肩关节脱位患者选择吸入七氟烷全身麻醉方式,麻醉效果良好,有利于提高复位成功率。

Objective： To study the inhaled sevoflurane general anesthesia methods advantages and disadvantages of patients with shoulder joint dislocation treated with traditional Chinese medicine repairing manipulation. Methods： 62 patients who conformed to the standard were randomly divided into sevoflurane group（ group A） and lidocaine group（ group B） and propofol group（ group C）. Group A（ 20 patients） chose inhalation sevoflurane general anesthesia. 21 cases in group B chose lidocaine brachial plexus block anesthesia and 21 cases in group C used propofol intravenous general anesthesia. The induction time and waking time were recorded and vital signs and adverse reactions were monitored. By VAS score method[3],the analgesic effect and physician satisfaction with self-made scale were used to assess the surgery. Results： A,B and C three groups＇ anesthesia excellent rates were 100%,76. 20% and 95. 25% respectively. Group A compared with group B,the difference was statistically significant（ P 〈0.05）. Group A compared with group C,there was no statistically significant difference（ P〉 0.05）. Group A and group C＇s anesthesia induction time,degree of pain scores and doctor gimmick reset time were successful and there was no statistically significant difference（ P 〉0. 05）. Anesthesia physician satisfaction and waking time were statistically significant（ P 〈 0. 05）. Compared with group B,group A＇s pain score,doctor gimmick reset time and successful surgery physician satisfaction had statistical significance（ P 〈0. 05）. Three groups during anesthesia and after treatment had no significant adverse reactions. Conclusion： The inhaled sevoflurane general anesthesia selection of patients with shoulder joint dislocation treated by manual reduction has good anesthesia effect and is conducive to improve the success rate reset.