羟考酮预防椎管内麻醉后寒战的临床观察

摘要

目的 观察羟考酮预防椎管内麻醉后寒战的临床效果.方法 选择拟在腰硬联合麻醉下行择期剖宫产手术的产妇150例,采用随机数字表法分为3组:Ο组(n=50)行腰硬联合麻醉,蛛网膜下腔注入0.75％布比卡因1.2 mL,胎儿娩出后,缓慢给予0.08 mg·kg-1羟考酮静脉注射;Ρ组(n=50)麻醉方法同 Ο组,胎儿娩出后给予哌替啶0.5 mg·kg-1静脉注射;C组(n=50)给予同样容量的生理盐水.观察各组用药后10 min时产妇的寒战分级,以及术中呼吸抑制、嗜睡及恶心、呕吐等不良反应发生情况.结果 Ο组、Ρ组寒战的发生率及程度均明显低于C组,O组和 Ρ组差异无统计学意义,Ρ组恶心、呕吐发生率高于O、C组.平均动脉压和心率组间差异无统计学意义.结论 羟考酮用于腰硬联合麻醉,可明显减少寒战反应,且对呼吸循环无明显抑制,恶心呕吐率低.%Objective To observe the effect of oxycodone hydrochloride injection on shivering during spinal anesthesia.Methods One hundred and fifty patients,scheduled for elective caesarean section under lumbar epidural anesthesia were randomly divided into 3 groups:Group O,Group P and Group C,50 cases in each.Lumbar epidural anesthesia was performed to all the patients in the 3 groups and 1 .2 mL bupivacaine was injected before operation,oxycodone hydrochloride injection of 0.08 mg·kg -1 was injected intravenously to patients in Group O,providing 0.5 mg·kg -1 to patients in Group P and normal saline 10 mL to patients in Group C.The scores of shivering and the adverse reaction such as respiratory depression,drowsiness,nausea and vomiting were observed at 10 minutes after in-jection.Results The incidence and degree of shivering in operation of the patients in Group O and Group P dropped down more than those of the patients in Group C.The incidence and degree of shivering between Group O and Group P was no obvious difference.The incidence of nausea and vomiting in operation of the patients in Group P went up more than those of the patients in Group O and Group C.Conclusions The application of oxycodone hydrochloride injection combined with lumbar epidural anesthesia in elective caesarean section is safe and effective.It can decrease the incidence of shivering,nausea and vomiting without obvious respiratory and circulatory depression.