摘要
目的探讨右美托咪定用于蛛网膜下腔阻滞对行剖宫产产妇术中寒战的预防作用。方法蛛网膜下腔阻滞下行剖宫产手术产妇40例,随机分为右美托咪定组与对照组各20例,胎儿娩出后,右美托咪定组经上肢静脉泵注右美托咪定0.5μg/(kg·h)至手术结束,对照组静脉泵注等剂量生理盐水。记录2组蛛网膜下腔阻滞前及注药5、10、20、30min和手术结束时收缩压、舒张压、心率与体温,比较2组注药后寒战发生率。结果右美托咪定组注药5、10、20min时收缩压((102±12)、(110±13)、(106±12)mm Hg)、舒张压((64±12)、(65±14)、(66±13)mm Hg)高于对照组((98±14)、(95±12)、(91±16)mm Hg和(56±11)、(55±13)、(57±15)mm Hg)(P<0.05);2组注药10、20、30min和手术结束时体温差异无统计学意义(P>0.05);右美托咪定组注药5、10、20、30min及手术结束时心率((82±12)、(81±14)、(80±13)、(78±9)、(76±11)次/min)低于对照组((92±13)、(92±16)、(87±15)、(86±12)、(87±14)次/min)(P<0.05);术中右美托咪定组出现寒战2例,对照组9例,2组寒战发生率(10%vs 45%)比较差异有统计学意义(P<0.05)。结论蛛网膜下腔阻滞下剖宫产手术产妇应用右美托咪定可维持血流动力学稳定,有效预防寒战发生。
Objective To explore the effect of dexmedetomdine infusion on preventing shivering during caesarean section under subarachnoid block.Methods Forty patients scheduled for caesarean section under subarachnoid block were divided into dexmedetomidine group and control group,with 20 patients in each group.Dexmedetomidine group received continuous intravenous pumping of 0.5μg/（kg·h）dexmedetomidine until the end of operation,while equal volume of normal saline was given to control group.Systolic and diastolic blood pressures,heart rate and temperature were measured before subarachnoid block,5,10,20 and 30min after dexmedetomidine infusion,and at the end of operation.The incidence of shivering was compared between two groups.Results The systolic blood pressures were（102±12）,（110±13）and（106±12）mm Hg,and the diastolic blood pressures were（64±12）,（65±14）and（66±13）mm Hg in dexmedetomidine group,higher than those in control group（（98±14）,（95±12）,（91±16）mm Hg;（56±11）,（55±13）,（57±15）mm Hg）（P〈0.05）at 5,10 and 20 min after dexmedetomidine pumping（P〈0.05）.There were no significant differences in the temperature between two groups at the time points of 5,10 and 20min after pumping and at the end of operation（P〉0.05）.The heart rates in dexmedetomidine group（（82±12）,（81±14）,（80±13）,（78±9）,（76±11）beat/min）were lower than those in control group（（92±13）,（92±16）,（87±15）,（86±12）,（87±14）beat/min）at the time points of 5,10,20 and 30min after pumping and at the end of operation（P〈0.05）.Shivering occurred in 2patients（10%）in dexmedetomidine group,and 9（45%）in control group,showing a significant difference between two groups（P 〈0.05）.Conclusion Dexmedetomidine can prevent perioperative shivering in patients undergoing caesarean section under subarachnoid block by maintaining hemodynamic stability.
出处
《中华实用诊断与治疗杂志》
2014年第12期1236-1238,共3页
Journal of Chinese Practical Diagnosis and Therapy
