氧化亚氮吸入镇痛在肩关节脱位手法复位手术中的应用效果

Application effects of nitrous oxide imbibition analgesia during manual reduction of shoulder dislocation

目的观察氧化亚氮吸入镇痛在肩关节脱位手法复位手术中的应用效果。方法接受手法复位治疗的肩关节脱位70例患者,随机分为对照组和试验组,每组35例。对照组采用1%利多卡因行肌间沟臂丛神经阻滞麻醉,试验组给予氧化亚氮吸入联合局部麻醉。比较2组生命体征[平均动脉压(MAP)、心率(HR)、呼吸频率(BR)]、麻醉情况、复位情况、镇痛效果、肩关节功能恢复情况、不良反应及满意度。结果对照组T1时MAP、HR均较T0时有所下降,差异有统计学意义(P<0.05),试验组各时间点MAP、HR、BR比较差异无统计学意义(P>0.05)。试验组麻醉诱导时间、麻醉苏醒时间、复位时间显著短于对照组,VAS评分、不良反应发生率显著低于对照组,麻醉优良率、复位成功率、满意度、ASES评分显著高于对照组,差异均有统计学意义(P<0.05)。结论肩关节脱位手法复位手术中应用氧化亚氮吸入麻醉效果、镇痛效果良好,能够显著提高复位成功率,且不良反应发生率低。

Objective To investigate the application effects of nitrous oxide imbibition analgesia during manual reduction of shoulder dislocation.Methods Seventy patients with shoulder dislocation who were treated by manual reduction were randomly divided into control group(n=35)and experimental group(n=35).The patients in control group were treated by intermuscular-groove brachial plexus block with 1%lidocaine,however,the patients in experimental group were treated by nitrous oxide inhalation combined with local anesthesia of lidocaine.The vital signs(MAP,HR and BR),anesthesia effects,reduction status,analgesic effects,functional recovery of shoulder joint,adverse reactions and satisfactory degree were observed and compared between the two groups.Results As compared with those at T0,the MAP and HR at T1 in control group were significantly decreased(P<0.05).There were no significant differences in MAP,HR and BR in experimental group at different time points(P>0.05).Moreover,the anesthesia induction time,waking time and reset time in experimental group were significantly shorter than those in control group,and the VAS scores and the incidence of adverse reactions in experimental group were significantly lower than those in control group.In addition,the good/excellent rate of anesthesia,the success rate of reduction,satisfactory degree and ASES scores in experimental group were significantly higher than those in control group(P<0.05).Conclusion The nitrous oxide inhalation during manual reduction of shoulder dislocation can increase the success rate of reduction markedly,with better analgesia effects and lower incidence of adverse reactions.