摘要
目的:观察右美托咪定对全麻下脊柱手术患者术后寒颤的治疗作用。方法:选择全身麻醉下行脊柱手术术后出现4级全身寒颤的患者60例,随机分为右美托咪定组(A组)、曲马多组(B组)及对照组(C组)。当寒颤持续5 min未自行缓解时,A、B、C组分别于5 min内静脉注射右美托咪定0.4μg/kg、曲马多1 mg/kg及等量生理盐水。记录3组患者给药前及给药后1 min、5 min、10 min的血压、心率、脉搏氧饱和度、寒颤程度及Ramsay镇静评分值;记录A、B两组患者寒颤治疗有效率、起效时间及给药60 min后的寒颤复发率;记录患者头晕、恶心、呕吐、呼吸抑制等不良反应发生率。结果:A组患者在给药5 min及10 min后Ramsay镇静评分值比B组及C组明显增高(P<0.05)。A组患者在给药5 min后寒颤治疗有效率比B组明显高(P<0.01),但在给药10 min后两组治疗有效率无明显差异。A组起效时间比B组明显缩短(P<0.01),而B组寒颤复发率比A组明显增高(P<0.05)。A组不良反应发生率比B组明显减少(P<0.05)。结论:静注0.4μg/kg右美托咪定可以快速而有效地治疗全麻术后寒颤,值得临床推广运用。
Objective：To observe the effects of dexmedetomidine on treating postoperative shivering in patients with general an-esthesia undergoing spinal surgery. Methods：Sixty patients with grade 4 of shivering after spinal surgery were assigned randomly into group A,B and C,respectively receiving an intravenous infusion of dexmedetomidine 0. 4μg/kg,tramadol 1 mg/kg,and equivalent nor-mal saline in 5 min. Mean arterial pressure （MAP）,heart rate （HR）,pulse oxygen saturation （SpO2）,grades of shivering and Ramsay sedation scores in three groups were recorded before medication and 1 min,5 min,10 min after medication. The effective rate, onset time,recurrence rate after 60 min and incidence of adverse reaction were also recorded. Results：The Ramsay sedation scores in group A at 5 min and 10 min after medication were higher than that in group B and group C,respectively （P〈0. 05）. The effective rate in group A at 5 min after medication was higher than that in group B （P〈0. 01）,but no significant difference was found between the two groups at 10 min after medication. The onset time of group A was shorter than that in group B （ P〈0. 01 ） and the recurrence rate in group B was higher than that in group A （P〈0. 05）. The incidence rate of adverse reaction in group A was lower than that in group B （P〈0. 05）. Conclusion：Dexmedetomidine 0. 4 μg/kg by intravenous infusion can treat postoperative shivering effectively,which is worthy for clinical application.
出处
《川北医学院学报》
CAS
2015年第2期191-194,共4页
Journal of North Sichuan Medical College
基金
空军总医院科研项目(kz2014013)
关键词
右美托咪定
曲马多
寒颤
全身麻醉
Dexmedetomidine
Tramadol
Shivering
General anesthesia
