小剂量氯胺酮注入硬膜外腔对经皮肾穿刺取石患者寒战的预防作用

摘要

目的 观察椎管内麻醉时硬膜外注入小剂量的氯胺酮(0.5 mg/kg)对经皮肾穿刺取石(PCNL)术患者寒战的预防作用.方法 选择60例在腰麻-硬膜外联合阻滞下行PCNL术患者,ASA Ⅰ～Ⅱ级,随机分成氯胺酮组(K组,n=30例)和对照组(C组,n=30例),K组硬膜外注入0.5 mg/kg氯胺酮(用生理盐水稀释至5 ml),C组硬膜外注入5 ml生理盐水.观察记录患者术中寒战的发生情况,并持续监测呼吸循环变化情况.结果 K组寒战发生率明显低于对照组(P＜0.05),两组患者术中HR、MAP和SpO2变化差异无统计学意义(P＞0.05).结论 硬膜外注射0.5 mg/kg氯胺酮可较好地预防PCNL术患者麻醉后寒战的发生.%Objective To observe the preventive effect of epidural injection with low-dose ofketamine on shivering undergoing percutaneous nephrolithotomy (PCNL). Methods Selected sixty ASA I ～ Ⅱ grade patients undergoing PCNL, aged 18-75 years, were randomly divided into ketamine group （K group, n=30, Epidural injection of 0.5 mg/kg ketamine, add saline to a total volume of 5 ml) and Control group (C group, n=30, Epidural injection of 5 ml normal saline ). The rate of shivering was observed and recorded during operation, and the blood pressure and respiration were measured. Results The rate of shivering in ketamine group was significantly lower than that in control group (P ＜ 0.05), There were no significant difference of HR, MAP and SpO2 between the two groups (P ＞ 0.05).Conclusion Epidural injection of 0.5 mg/kg ketamine can prevent shivering in PCNL.