右美托咪定预防腰硬联合麻醉期间寒战效果的观察

摘要

Objective To investigate the efficacy of dexmedetomidine in the prevention of shivering during combined spinal-epidural anesthesia.Methods 60 patients undergoing operation after combined spinal-epidural anesthesia were randomized into 2 groups with 30 cases in each group(Group D and Group C).0.6 μg·kg -1 dexmedetomidine or normal saline was intravenously infused to patients in Group D or Group C respectively.The incidence of shivering and hemodynamics during anesthesia were observed according to pre-scheduled time points.Results The incidence of shivering in Group D as 13.3% was significantly lower than that in Group C as 43.3%(P <0.05).The temperature in Group D was lower than Group C at T3-T6 time point.Systolic arterial blood pressure(SBP) was lower in Group C than in Group D at T2-T5 time point.The heart rate(HR)was lower in Group D than in Group C at T1-T6 time point.Conclusions Dexmedetomidine can effectively and safely prevent shivering during combined spinal-epidural anesthesia and sta-bilize hemodynamics continuously.%目的：探讨右美托咪定对腰硬联合麻醉期间寒战反应的预防效果。方法选择行腰硬联合麻醉手术患者60例，随机数字表法均分为2组，每组30例。麻醉开始分别静注右美托咪定0．6μg·kg －1（D 组）和生理盐水（C 组）。按照设定的时间记录患者麻醉期间寒战发生情况和血流动力学的变化。结果D 组患者麻醉期间寒战发生率为13．3％，明显低于 C 组的43．3％（P ＜0．05），D 组患者腋下体温在 T3～T6时点低于 C 组（P ＜0．05）；D 组患者麻醉后在 T2～T5时点收缩压明显高于 C组（P ＜0．05），并且心率在 T1-T6时点心率明显低于 C 组（P ＜0．05）。结论右美托咪定可有效安全地预防腰硬联合麻醉期间的寒战反应，并且能维持稳定的血流动力学。