Frymann S J, Cumberbatch G L A, Stearman A S L
Emergency Department, Salisbury District Hospital, Salisbury, UK.
Emerg Med J. 2005 Nov;22(11):807-9. doi: 10.1136/emj.2003.011809.
This prospective observational study aimed to determine the rate of success of reduction of dislocated hip prostheses using conscious sedation. In 101 consecutive patients presenting to the emergency department between August 2000 and February 2003 with a dislocated hip prosthesis, reduction was attempted using conscious sedation. The outcome measures of the study were (a) rate of success of the attempted reductions (b) rate of complication of the sedation or the procedure, and (c) rate of success in the three subgroups (based on degree of dislocation). The overall success rate was 62% (95% CI 53% to 71%). There were six complications: five related to sedation and one was a mild foot drop. The mean time to attempted reduction using conscious sedation was 1.83 hours and for an equivalent group who were excluded and subsequently required general anaesthesia the mean time was 10.9 hours. Reduction of isolated unilateral prosthetic hip dislocation using conscious sedation in the emergency department is safe and has a reasonable success rate. Prosthetic hip reduction can be attempted more quickly using conscious sedation than when awaiting general anaesthesia.
这项前瞻性观察性研究旨在确定使用清醒镇静复位脱位髋关节假体的成功率。在2000年8月至2003年2月期间连续101例因髋关节假体脱位就诊于急诊科的患者中，尝试使用清醒镇静进行复位。该研究的结果指标为：（a）尝试复位的成功率；（b）镇静或操作的并发症发生率；（c）三个亚组（根据脱位程度）的成功率。总体成功率为62%（95%可信区间53%至71%）。有6例并发症：5例与镇静有关，1例为轻度足下垂。使用清醒镇静尝试复位的平均时间为1.83小时，而在被排除随后需要全身麻醉的同等组中，平均时间为10.9小时。在急诊科使用清醒镇静复位孤立性单侧人工髋关节脱位是安全的，且成功率合理。与等待全身麻醉相比，使用清醒镇静可以更快地尝试进行人工髋关节复位。
