何平, 翟明, 王涛涛, 王南海. 右美托咪定与地佐辛预防椎管内麻醉后寒战的效果比较[J]. 蚌埠医科大学学报, 2016, 41(10): 1319-1322. DOI: 10.13898/j.cnki.issn.1000-2200.2016.10.019
    引用本文: 何平, 翟明, 王涛涛, 王南海. 右美托咪定与地佐辛预防椎管内麻醉后寒战的效果比较[J]. 蚌埠医科大学学报, 2016, 41(10): 1319-1322. DOI: 10.13898/j.cnki.issn.1000-2200.2016.10.019
    HE Ping, ZHAI Ming, WANG Tao-tao, WANG Nan-hai. The effect comparison between dexmedetomidine and dezocine in the prevention of shivering after spinal canal anesthesia[J]. Journal of Bengbu Medical University, 2016, 41(10): 1319-1322. DOI: 10.13898/j.cnki.issn.1000-2200.2016.10.019
    Citation: HE Ping, ZHAI Ming, WANG Tao-tao, WANG Nan-hai. The effect comparison between dexmedetomidine and dezocine in the prevention of shivering after spinal canal anesthesia[J]. Journal of Bengbu Medical University, 2016, 41(10): 1319-1322. DOI: 10.13898/j.cnki.issn.1000-2200.2016.10.019

    右美托咪定与地佐辛预防椎管内麻醉后寒战的效果比较

    The effect comparison between dexmedetomidine and dezocine in the prevention of shivering after spinal canal anesthesia

    • 摘要: 目的:比较右美托咪定与地佐辛预防椎管内麻醉后寒战反应的效果。方法:择期椎管内麻醉下行单侧膝关节置换手术的骨科患者90例,随机分为D组(右美托咪定0.5 μg/kg)、Z组(地佐辛0.1 mg/kg)及C组(0.9%氯化钠注射液),各30例。所有患者均采用L2~3腰硬联合麻醉,麻醉平面固定后,微量注射泵输注相应药物。观察麻醉后寒战反应及分级、氧饱和度情况,恶心、呕吐不良反应发生情况,并记录患者麻醉平面固定后(T0)、药物泵注结束时(T1)、手术开始30 min(T2)和60 min(T3)及手术结束(T4)时的心率(HR)、平均动脉压(MAP)及Ramsay镇静评分。结果:D、Z、C组的寒战分级以及恶心呕吐发生率差异均有统计学意义(P<0.05);D组和Z组在T3和T4时间点的HR均较C组降低(P<0.01);3组间T0~T4MAP差异均无统计学意义(P>0.05);D组镇静效果在T1~T4时间点均优于Z组和C组(P<0.01),且无过度镇静现象。结论:右美托咪定既能有效降低椎管内麻醉后寒战的发生率,又具备良好的镇静作用,且不增加麻醉后的不良反应发生率,适合临床应用。

       

      Abstract: Objective: To compare the preventive effects between dexmedetomidine and dezocine on shivering after spinal canal anesthesia.Methods: Ninety patients scheduled by unilateral knee replacement surgery under spinal canal anesthesia were randomly divided into the group D(using 0.5 μg/kg of dexmedetomidine),group Z(using 0.1 mg/kg of dezocine) and group C(using 0.9% of sodium chloride injection) (30 cases each group).All patients were anesthetized at L2-L3 using combined spinal and epidural anesthesia(CSEA).The drugs were pumped into after fixing anesthesia plane.The reaction and grading of shivering,oxygen saturation,nausea and vomiting were observed after the CSEA.The HR,MAP and Ramsay scores were recorded at the time of fixing anesthesia plane(T0),end of drug injection(T1),after 30 and 60 min of operation(T2 and T3) and end of operatiom(T4).Results: The differences of the shivering classification,and incidence of nausea and vomiting among group D,Z and C were statistically significant(P<0.05).The HR in group D and Z at T3 and T4 were less than those in group C(P<0.01).The differences of the MAP at T0 to T4 among the 3 groups were not statistically significant(P>0.05).The sedative effects in group D at T1 to T4 were better than that in group Z and C(P<0.01),and no excessive sedation was identified.Conclusions: The dexmedetomidine can effectively decrease the incidence of shivering after CSEA,has good sedative effect,and does not increase the incidence of postoperative adverse reaction,which is suitable for clinical application.

       

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