中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2013年
33期
30-32
,共3页
薛兴%杜丽芳%秦玫%范坤%张晓兰
薛興%杜麗芳%秦玫%範坤%張曉蘭
설흥%두려방%진매%범곤%장효란
氯胺酮%剖宫产术%寒战%静脉注射
氯胺酮%剖宮產術%寒戰%靜脈註射
록알동%부궁산술%한전%정맥주사
Ketamine%Caesarean section%Shivering%Intravenous
目的 探讨小剂量氯胺酮预先静脉注射对蛛网膜下隙与硬膜外腔联合阻滞麻醉下剖宫产手术患者寒战预防的有效性和安全性.方法 90例拟在蛛网膜下隙与硬膜外腔联合阻滞麻醉下行剖宫产手术的患者,按随机数字表法分为3组:对照组(30例)、低剂量氯胺酮组(30例)、高剂量氯胺酮组(30例),手术消毒前对照组经静脉注入3 ml 0.9％氯化钠,低剂量氯胺酮组经静脉注入0.25 mg/kg(3 ml)氯胺酮,高剂量氯胺酮组经静脉注入0.50 mg/kg(3 ml)氯胺酮.分别记录麻醉前、麻醉后15 min、麻醉后30 min、术后1h的寒战发生率及不良事件发生情况.结果 对照组麻醉后15 min、30 min及术后1h平均动脉压(MAP)[(62±10)、(58±8)、(61±11) mm Hg(1 mm Hg=0.133 kPa)]明显低于高剂量氯胺酮组[(78±12)、(82±8)、(76±11) mm Hg]和低剂量氯胺酮组[(72±10)、(76±6)、(80±7)mm Hg],差异有统计学意义(P＜0.05).高剂量氯胺酮组和低剂量氯胺酮组无一例需要治疗的寒战发生.低剂量氯胺酮组幻觉和眼球震颤的发生率[0、6.7％(2/30)]低于高剂量氯胺酮组[20.0％(6/30)、50.0％ (15/30)],差异有统计学意义(P＜0.05).结论 预防性静脉注射小剂量氯胺酮(0.25 mg/kg)对蛛网膜下隙与硬膜外腔联合阻滞麻醉下剖宫产手术寒战的发生具有很好的防治效果.
目的 探討小劑量氯胺酮預先靜脈註射對蛛網膜下隙與硬膜外腔聯閤阻滯痳醉下剖宮產手術患者寒戰預防的有效性和安全性.方法 90例擬在蛛網膜下隙與硬膜外腔聯閤阻滯痳醉下行剖宮產手術的患者,按隨機數字錶法分為3組:對照組(30例)、低劑量氯胺酮組(30例)、高劑量氯胺酮組(30例),手術消毒前對照組經靜脈註入3 ml 0.9％氯化鈉,低劑量氯胺酮組經靜脈註入0.25 mg/kg(3 ml)氯胺酮,高劑量氯胺酮組經靜脈註入0.50 mg/kg(3 ml)氯胺酮.分彆記錄痳醉前、痳醉後15 min、痳醉後30 min、術後1h的寒戰髮生率及不良事件髮生情況.結果 對照組痳醉後15 min、30 min及術後1h平均動脈壓(MAP)[(62±10)、(58±8)、(61±11) mm Hg(1 mm Hg=0.133 kPa)]明顯低于高劑量氯胺酮組[(78±12)、(82±8)、(76±11) mm Hg]和低劑量氯胺酮組[(72±10)、(76±6)、(80±7)mm Hg],差異有統計學意義(P＜0.05).高劑量氯胺酮組和低劑量氯胺酮組無一例需要治療的寒戰髮生.低劑量氯胺酮組幻覺和眼毬震顫的髮生率[0、6.7％(2/30)]低于高劑量氯胺酮組[20.0％(6/30)、50.0％ (15/30)],差異有統計學意義(P＜0.05).結論 預防性靜脈註射小劑量氯胺酮(0.25 mg/kg)對蛛網膜下隙與硬膜外腔聯閤阻滯痳醉下剖宮產手術寒戰的髮生具有很好的防治效果.
목적 탐토소제량록알동예선정맥주사대주망막하극여경막외강연합조체마취하부궁산수술환자한전예방적유효성화안전성.방법 90례의재주망막하극여경막외강연합조체마취하행부궁산수술적환자,안수궤수자표법분위3조:대조조(30례)、저제량록알동조(30례)、고제량록알동조(30례),수술소독전대조조경정맥주입3 ml 0.9％록화납,저제량록알동조경정맥주입0.25 mg/kg(3 ml)록알동,고제량록알동조경정맥주입0.50 mg/kg(3 ml)록알동.분별기록마취전、마취후15 min、마취후30 min、술후1h적한전발생솔급불량사건발생정황.결과 대조조마취후15 min、30 min급술후1h평균동맥압(MAP)[(62±10)、(58±8)、(61±11) mm Hg(1 mm Hg=0.133 kPa)]명현저우고제량록알동조[(78±12)、(82±8)、(76±11) mm Hg]화저제량록알동조[(72±10)、(76±6)、(80±7)mm Hg],차이유통계학의의(P＜0.05).고제량록알동조화저제량록알동조무일례수요치료적한전발생.저제량록알동조환각화안구진전적발생솔[0、6.7％(2/30)]저우고제량록알동조[20.0％(6/30)、50.0％ (15/30)],차이유통계학의의(P＜0.05).결론 예방성정맥주사소제량록알동(0.25 mg/kg)대주망막하극여경막외강연합조체마취하부궁산수술한전적발생구유흔호적방치효과.
Objective To explore the efficacy and safety of low-dose ketamine for prevention of shivering during cesarean section under subarachnoid space and epidural anesthesia.Methods Ninety pregnant women who scheduled cesarean delivery under subarachnoid space and epidural anesthesia were randomized divided into three groups:control group (30 patients) low-dose ketamine group (30 patients) and high-dose ketamine group (30 patients).0.9％ sodium chloride,0.25 mg/kg(3 ml),and 0.50 mg/kg (3 ml) ketamine were given in three groups before operation.The incidence of shivering and adverse effect were recorded respectively before anesthesia,after anesthesia 15 min and 30 min and after operation 1 h.Results The level of mean arterial pressure (MAP) in control group after anesthesia 15 main and 30 min and after operation 1 h[(62 ± 10),(58 ± 8),(61 ± 11) mm Hg(1 mm Hg =0.133 kPa)] were significantly lower than those in high-dose ketamine group [(78 ± 12),(82 ± 8),(76 ± 11)mm Hg] and low-dose ketamine group [(72 ± 10),(76 ± 6),(80 ± 7) mm Hg],there was significant difference (P ＜ 0.05).There was no shivering need treat in low-dose ketamine group and high-dose ketamine group.The rate of hallucinations and nystagmus in low-dose ketamine group [0,6.7％ (2/30)] was significantly lower than that in high-dose ketamine group [20.0％ (6/30),50.0％ (15/30)],there was significant difference (P ＜ 0.05).Conclusion The pretreatment with low-dose ketamine on shivering during cesarean section under subarachnoid space and epidural anesthesia has better preventive effectiveness,0.25 mg/kg of ketamine is more effective than 0.50mg/kg.
