中国医药
中國醫藥
중국의약
CHINA MEDICINE
2012年
12期
1578-1580
,共3页
王晓宁%刘丽%汪润%赵斌江%冯艺
王曉寧%劉麗%汪潤%趙斌江%馮藝
왕효저%류려%왕윤%조빈강%풍예
寒战%曲马多%麻醉前用药%区域麻醉%剖宫产术
寒戰%麯馬多%痳醉前用藥%區域痳醉%剖宮產術
한전%곡마다%마취전용약%구역마취%부궁산술
Shivering%Tramadol%Preanesthetic medication%Regional anesthesia%Cesarean section
目的 观察低剂量曲马多预处理对剖宫产术蛛网膜下腔麻醉后寒战的预防作用.方法 择期行剖宫产手术产妇90例,年龄21～43岁,美国麻醉医师协会分级Ⅰ～Ⅱ级.采用随机数字表法将产妇随机分为对照组(蛛网膜下腔麻醉给药前30 min静脉推注0.9％氯化钠注射液5ml,30例)、观察组A(蛛网膜下腔麻醉给药前30 min静脉推注盐酸曲马多0.5 mg/kg,30例)、观察组B(蛛网膜下腔麻醉给药前30 min静脉推注盐酸曲马多1.0 mg/kg,30例).3组注药时间均为10 s.记录麻醉开始至手术结束后6h内寒战、镇静、恶心、呕吐、眩晕、低血压、心动过缓、呼吸抑制等不良反应发生情况和新生儿的Apgar评分.结果 对照组、观察组A和观察组B寒战发生率分别为40.0％ (12/30)、13.3％ (4/30)和10.0％ (3/30),与对照组比较,观察组A和观察组B寒战发生率均较低,组间比较差异有统计学意义(P＜0.05),观察组A与观察组B间的差异无统计学意义(P＞0.05).对照组、观察组A和观察组B镇静发生率分别为6.7％ (2/30)、23.3％(7/30)、46.7％(14/30),对照组和观察组A镇静发生率明显低于观察组B,组间差异有统计学意义(P＜0.05).3组均未发生眩晕、过度镇静和呼吸抑制且术中低血压、心动过缓发生率组间差异无统计学意义(P＞0.05).结论 与曲马多1.0 mg/kg相比,曲马多0.5 mg/kg预处理能够有效地预防蛛网膜下腔麻醉后产妇的寒战反应,且不良反应发生率减低.
目的 觀察低劑量麯馬多預處理對剖宮產術蛛網膜下腔痳醉後寒戰的預防作用.方法 擇期行剖宮產手術產婦90例,年齡21～43歲,美國痳醉醫師協會分級Ⅰ～Ⅱ級.採用隨機數字錶法將產婦隨機分為對照組(蛛網膜下腔痳醉給藥前30 min靜脈推註0.9％氯化鈉註射液5ml,30例)、觀察組A(蛛網膜下腔痳醉給藥前30 min靜脈推註鹽痠麯馬多0.5 mg/kg,30例)、觀察組B(蛛網膜下腔痳醉給藥前30 min靜脈推註鹽痠麯馬多1.0 mg/kg,30例).3組註藥時間均為10 s.記錄痳醉開始至手術結束後6h內寒戰、鎮靜、噁心、嘔吐、眩暈、低血壓、心動過緩、呼吸抑製等不良反應髮生情況和新生兒的Apgar評分.結果 對照組、觀察組A和觀察組B寒戰髮生率分彆為40.0％ (12/30)、13.3％ (4/30)和10.0％ (3/30),與對照組比較,觀察組A和觀察組B寒戰髮生率均較低,組間比較差異有統計學意義(P＜0.05),觀察組A與觀察組B間的差異無統計學意義(P＞0.05).對照組、觀察組A和觀察組B鎮靜髮生率分彆為6.7％ (2/30)、23.3％(7/30)、46.7％(14/30),對照組和觀察組A鎮靜髮生率明顯低于觀察組B,組間差異有統計學意義(P＜0.05).3組均未髮生眩暈、過度鎮靜和呼吸抑製且術中低血壓、心動過緩髮生率組間差異無統計學意義(P＞0.05).結論 與麯馬多1.0 mg/kg相比,麯馬多0.5 mg/kg預處理能夠有效地預防蛛網膜下腔痳醉後產婦的寒戰反應,且不良反應髮生率減低.
목적 관찰저제량곡마다예처리대부궁산술주망막하강마취후한전적예방작용.방법 택기행부궁산수술산부90례,년령21～43세,미국마취의사협회분급Ⅰ～Ⅱ급.채용수궤수자표법장산부수궤분위대조조(주망막하강마취급약전30 min정맥추주0.9％록화납주사액5ml,30례)、관찰조A(주망막하강마취급약전30 min정맥추주염산곡마다0.5 mg/kg,30례)、관찰조B(주망막하강마취급약전30 min정맥추주염산곡마다1.0 mg/kg,30례).3조주약시간균위10 s.기록마취개시지수술결속후6h내한전、진정、악심、구토、현훈、저혈압、심동과완、호흡억제등불량반응발생정황화신생인적Apgar평분.결과 대조조、관찰조A화관찰조B한전발생솔분별위40.0％ (12/30)、13.3％ (4/30)화10.0％ (3/30),여대조조비교,관찰조A화관찰조B한전발생솔균교저,조간비교차이유통계학의의(P＜0.05),관찰조A여관찰조B간적차이무통계학의의(P＞0.05).대조조、관찰조A화관찰조B진정발생솔분별위6.7％ (2/30)、23.3％(7/30)、46.7％(14/30),대조조화관찰조A진정발생솔명현저우관찰조B,조간차이유통계학의의(P＜0.05).3조균미발생현훈、과도진정화호흡억제차술중저혈압、심동과완발생솔조간차이무통계학의의(P＞0.05).결론 여곡마다1.0 mg/kg상비,곡마다0.5 mg/kg예처리능구유효지예방주망막하강마취후산부적한전반응,차불량반응발생솔감저.
Objective To evaluate the effect of low dose tramadol on prophylaxis of shivering during spinal anaesthesia.Methods In this prospective,randomized and double-blind study,90 cases American society of anesthesiologists(ASA) Ⅰ and Ⅱ patients ranging 21-43 years old undergoing selective cesarean section were included.The patients were randomly allocated to the control group (0.9％ normal saline were given as an intravenous bolus 30 min before intrathecal injection,n =30) ; observation group A (tramadol 0.5 mg/kg were given as an intravenous bolus 30 min before intrathecal injection,n =30) ; observation group B (tramadol 1.0 mg/kg were given as an intravenous bolus 30 min before intrathecal injection,n =30).All drugs were given as a bolus of 5 millilitres in 10 seconds.From the start of anaesthesia to 6 hours after surgery,the complications including shivering,oversedation,nausea,vomiting and dizziness; the Apgar scores of the newborns was observed.Results The incidence of shivering in the control group,observation group A and B was 40.0％ (12/30),13.3％ (4/30)and 10.0％ (3/30) respectively.Compared with the control group,the incidence of shivering in both observation group A and B was significantly lower (P ＜ 0.05) ; no statistical difference was observed between observation group A and B.The incidences of sedation in the control group,observation group A and B were 6.7％ (2/30),23.3％ (7/30) and 46.7％ (14/30) respectively.The incidence of sedation in the control group and observation group A was significantly lower than that in observation group B (P ＜ 0.05).No dizziness,oversedation or respiratory depression was observed in three groups and there was no statistics difference in the incidences of hypotension and bradycardia among three groups (P ＞ 0.05).Conclusions Compared with tramadol 1mg/kg,preconditioning tramadol 0.5mg/kg is alsó effective for prophylaxis of shivering during subarachnoid anaesthesia in patients undergoing cesarean section.Moreover,the incidence of complications can be reduced.
