右美托咪啶与哌替啶处置经尿道前列腺电切术寒战效果比较

摘要

目的 比较右美托咪啶和哌替啶处置经尿道前列腺电切术中寒战反应效果.方法 在硬腰联合麻醉下前列腺电切术中发生寒战的老年患者60例,随机分为右美托咪啶组(A组)和哌替啶组(B组),每组30例.出现寒战后,A组静推右美托咪啶0.5 μg·kg-1,B组静推哌替啶0.4 mg·kg-1,均10 min推注完.观察两组患者用药后寒战的转归、生命体征变化和不良反应,术毕随访患者满意度.结果 组间比较寒战治疗有效率相近,用药后5 min(T2)、15 min (T3)、30 min(T4)血压、心率与用药前(T1)相比均显著下降(P<0.01).镇静评分及术毕满意度A组优于B组(P<0.05).不良反应B组明显多于A组(P<0.05).结论 右美托咪啶可安全、有效地处置老年患者前列腺电切术中的寒战,不良反应少.%Objective To compare the effect of Dexmedetomidine( Dei) and Pethidine to deal with the operative shivering in transurethral resection of the prostate ( TURP) . Methods Sixty aged patients, undergoing TURP in the condition of spinal-epidural anesthesia, were randomly assigned into two groups;Dexmedetomidine(Dex) (group A) and Pethidine(group B) . When shivering occured,Group A were treated with intravenous pumping Dex(0. 5 μg · kg-1) whereas Group B were given pethidine(0.4 mg · kg-1) ;both procedures took ten minutes. We observed the outcomes of shivering, changes of vital signs and adverse reactions in two groups after using drugs,and recorded the follow-up survey on the patients' satisfaction. Results The efficiency of the treatment of shivering in two groups had no significant difference(P>0. 05). BP and HR of two groups all dropped significantly at the point of 5 min(T2) ,15 min(T3) ,30 min(T4) after u-sing drugs compared with the point before puming(Tl) (P <0. 01) . Group A surpassed group B in RSS score and the patients' satisfaction (0.05) .meanwhile, group B greatly outnumbered group A in adverse reactions(P < 0. 05) . Conclusion Dexmedetomidine is deemed as safe,reliable and feasible to release the shivering of TURP in the aged patients with less adverse reactions.