吸入低剂量甲氧基氟醚支持肩关节前脱位Cunningham复位术的初步研究

IF 0.3 Q4 EMERGENCY MEDICINE Eurasian Journal of Emergency Medicine Pub Date : 2022-12-09 DOI:10.4274/eajem.galenos.2022.03206
Samuel Campbell, H. Wiemer, Ryan Fitzpatrick, C. Carriere, S. Teed, P. Hico, A. Snook
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引用次数: 0

摘要

目的:Cunningham方法可以在不使用镇静和镇痛(PSA)的情况下复位一些患者的前肩脱位(ASD)。本初步研究评估了吸入甲氧基氟醚(I-MEOF)是否能提高ASD坎宁安减法成功率的可行性。材料与方法:20例无并发症ASD患者采用Cunningham方法配合I-MEOF镇痛(Cunningham/I-MEOF)进行复位尝试。结果包括不需要PSA的成功率,急诊科住院时间(LOS),以及操作者和患者的满意度。结果:入组患者中。80%为男性,中位年龄38.6岁(18-71岁),55%为首次脱位。35%(8/20)患者使用Cunningham/I-MEOF成功复位。其余患者在PSA下进行了成功的闭合复位。60%的操作人员对该过程表示满意或非常满意。术者认为最初复位失败的主要原因是肌肉放松不足。80%的患者报告了良好到极好的满意度。Cunningham/I-MEOF初始复位成功的患者平均LOS为149分钟,而PSA下继续复位的患者平均LOS为216分钟。结论:使用I-MEOF, Cunningham技术减少ASD的成功率略有增加,尽管65%的患者仍然需要PSA来促进减少。提供者和患者都认为这个过程总体上令人满意,这表明早期镇痛是值得赞赏的。
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A Pilot Study of Inhaled Low-dose Methoxyflurane to Support Cunningham Reduction of Anterior Shoulder Dislocation
Aim: The Cunningham method allows for the reduction of anterior shoulder dislocations (ASD) without procedural sedation and analgesia (PSA) in some patients. This pilot study evaluates the feasibility of investigating whether the administration of inhaled methoxyflurane (I-MEOF) increases the success rate of Cunningham reduction of ASD. Materials and Methods: Twenty patients with uncomplicated ASD underwent reduction attempts using the Cunningham method supported by I-MEOF analgesia (Cunningham/I-MEOF). Outcomes included the success rate without the requirement for PSA, emergency department length of stay (LOS), and operator and patient satisfaction. Results: Of the patients enrolled. 80% were male, median age was 38.6 years (range 18-71) and 55% were the first dislocations. 35% (8/20 patients) were successfully reduced using Cunningham/I-MEOF. The remainder of patients proceeded to successful closed reduction under PSA. 60% of operators reported good to excellent satisfaction with the process. Operators identified the primary cause of failed initial reduction attempts as inadequate muscle relaxation. 80% of patients reported good to excellent satisfaction. Patients whose initial reduction attempt with Cunningham/I-MEOF was successful had an average LOS of 149 min, compared with 216 min for those who proceeded to reduction under PSA. Conclusion: Success with ASD reduction by the Cunningham technique was marginally increased with the use of I-MEOF, although 65% of patients still required PSA to facilitate reduction. Both providers and patients found the process generally satisfactory, suggesting that early administration of analgesia is appreciated.
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