CAJ | 학술논문

目的观察鞘内注射不同剂量的哌替啶对剖宫产患者寒战的影响.方法 60例ASA分级Ⅰ～Ⅱ级剖宫产患者按随机数字表法分为四组,每组15例,均采用蛛网膜下隙联合硬膜外麻醉(腰硬联合麻醉).A组蛛网膜下隙麻醉药为0.5％布比卡因10 mg;B组蛛网膜下隙麻醉药为0.5％布比卡因10mg+5％哌替啶5 mg;C组蛛网膜下隙麻醉药为0.5％布比卡因10 mg+ 5％哌替啶10mg;D组蛛网膜下隙麻醉药为0.5％布比卡因10 mg+ 5％哌替啶15 mg.分别于麻醉后10、20、30、60 min记录寒战发生例数与级别、生命体征(血压、心率、体温、呼吸频率、脉搏血氧饱和度),恶心呕吐发生情况,胎儿取出后1、5 min Apgar评分.结果所有患者均顺利完成手术,未出现意外.四组各时间点生命体征、恶心呕吐发生例数及新生儿1、5 min Apgar评分比较差异均无统计学意义(P＞0.05).A组寒战发生例数明显多于B、C、D组(11例比2、1、1例),差异有统计学意义(P＜0.01);A组3级寒战发生例数明显多于B、C、D组(4例比0、0、0例),差异有统计学意义(P＜0.01).结论腰硬联合麻醉时鞘内注射哌替啶5～15 mg能有效防止剖宫产术中寒战的发生.
목적 관찰초내주사불동제량적고체정대부궁산환자한전적영향.방법 60례ASA분급Ⅰ～Ⅱ급부궁산환자안수궤수자표법분위사조,매조15례,균채용주망막하극연합경막외마취(요경연합마취).A조주망막하극마취약위0.5％포비잡인10 mg;B조주망막하극마취약위0.5％포비잡인10mg+5％고체정5 mg;C조주망막하극마취약위0.5％포비잡인10 mg+ 5％고체정10mg;D조주망막하극마취약위0.5％포비잡인10 mg+ 5％고체정15 mg.분별우마취후10、20、30、60 min기록한전발생례수여급별、생명체정(혈압、심솔、체온、호흡빈솔、맥박혈양포화도),악심구토발생정황,태인취출후1、5 min Apgar평분.결과 소유환자균순리완성수술,미출현의외.사조각시간점생명체정、악심구토발생례수급신생인1、5 min Apgar평분비교차이균무통계학의의(P＞0.05).A조한전발생례수명현다우B、C、D조(11례비2、1、1례),차이유통계학의의(P＜0.01);A조3급한전발생례수명현다우B、C、D조(4례비0、0、0례),차이유통계학의의(P＜0.01).결론 요경연합마취시초내주사고체정5～15 mg능유효방지부궁산술중한전적발생.
Objective To investigate the effect of different intrathecal doses of meperidine on shivering during cesarean delivery under spinal-epidural anesthesia.Methods Sixty parturient women,ASA grade Ⅰ-Ⅱ grade,scheduled for cesarean delivery were enrolled in four groups by random digits table with 15 cases each group.All patients underwent combined spinal-epidural anesthesia.Spinal anesthesia consisted of isobaric bupivacaine 0.5％ (10 mg) in the standard group (group A),isobaric bupivacaine 0.5％ (10 mg) plus 5 mg meperidine in group B,isobaric bupivacaine 0.5％ (10 mg) plus 10 mg meperidine in group C,isobaric bupivacaine 0.5％(10 mg) plus 15 mg meperidine in group D.The signs and symptoms were recorded 10,20,30,60 min after anesthesia respectively.Results All patients were successfully operated,not unexpected.Four groups at each time point of vital signs,nausea and vomiting,and the number of cases of neonatal 1,5 min Apgar scores was no significant difference (P ＞ 0.05).Group A of shivering and the third grade shivering were significantly more than the number of group B,C,D(11 cases vs.2,1,1 cases;4 cases vs.0,0,0 cases,P＜ 0.01).Conclusion Epidural anesthesia,intrathecal meperidine 5-15 mg can effectively prevent shivering in cesarean section.