目的：观察不同剂量右美托咪定对妇科腹腔镜手术患者全麻后寒战的预防作用。方法：全麻下行妇科腹腔镜手术的患者120例随机分为四组：术前单次静脉缓慢注射0．9％生理盐水（S 组）、右美托咪定0．5μg/kg（D0．5组）、0．75μg/kg（D0．75组）、1．0μg/kg（D1．0组），注射时间＞10 min。记录麻醉诱导前基础体温，插管及拔管即刻、插管及拔管后20、40 min 肛温、HR ，拔管时间（从停止吸入七氟醚到拔除气管导管），观察并记录入 PACU 后即刻，20、40 min VAS 评分、寒战分级、术后镇静/警觉（ OAA/S ）评分。结果：和S 组比较，D0．5组，D0．75组和 D1．0组在拔管后20、40 min 的体温（T）明显降低，与 S 组比较 D0．75组和D1．0组插管后20、40 min 的心率明显减慢（P＜0．05），拔管时间明显延长（P＜0．05）；术后寒战发生率明显减低（P＜0．05）；VAS评分和镇静/警觉（OAA/S）评分明显降低（P＜0．05）。结论：术前单次静脉缓慢注射右美托咪定0．75μg/kg和1μg/kg均可有效减少妇科腹腔镜手术患者全麻术后寒战的发生。%Objective The aim of this study was to investigate different dosages and effects of dexmedetomidine for prevention of postanesthetic shivering. Methods One-hundred twenty patients scheduled for laparoscopic surgery were randomly allocated in four groups: before the operation, slowly injected 0.9% normal saline (group S, dexmedetomidine 0.5 μg/kg (group D0.5), dexmedetomidine 0.75 μg/kg (group D0.75), dexmedetomidine 1.0 μg/kg(group D1.0). HR and rectal temperature[C2] were continually monitered during and after operation, time to extubation was measured. Grades of shivering were recorded. Pain evaluation was assessed by a visual analogue scale, sedation was evaluated by Modified Observer′s Assessment of Alertness/Sedation scale. Results The patients in group S showed a significantly higher HR and postoperative incidence of shivering than those in group D0.75 and group D1.0, (P < 0.05). but the extubation time in groupd D0.75 and group D1.0 were longer than patients in group S (P<0.05). Conclusion Slowly injected dexmedetomidine 0.75 μg/kg or 1.0 μg/kg can prevent postanesthetic shivering in laparoscopic surgery effectively.
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