川北医学院学报
川北醫學院學報
천북의학원학보
JOURNAL OF NORTH SICHUAN MEDICAL COLLEGE
2015年
2期
191-194
,共4页
右美托咪定%曲马多%寒颤%全身麻醉
右美託咪定%麯馬多%寒顫%全身痳醉
우미탁미정%곡마다%한전%전신마취
Dexmedetomidine%Tramadol%Shivering%General anesthesia
目的::观察右美托咪定对全麻下脊柱手术患者术后寒颤的治疗作用。方法:选择全身麻醉下行脊柱手术术后出现4级全身寒颤的患者60例,随机分为右美托咪定组( A组)、曲马多组( B组)及对照组( C组)。当寒颤持续5 min未自行缓解时,A、B、C 组分别于5 min内静脉注射右美托咪定0.4μg/kg、曲马多1 mg/kg及等量生理盐水。记录3组患者给药前及给药后1 min、5 min、10 min的血压、心率、脉搏氧饱和度、寒颤程度及Ramsay镇静评分值;记录A、B两组患者寒颤治疗有效率、起效时间及给药60 min后的寒颤复发率;记录患者头晕、恶心、呕吐、呼吸抑制等不良反应发生率。结果: A组患者在给药5 min及10 min后Ramsay镇静评分值比B组及C组明显增高(P<0.05)。 A组患者在给药5 min后寒颤治疗有效率比B组明显高(P<0.01),但在给药10 min后两组治疗有效率无明显差异。 A组起效时间比B组明显缩短(P<0.01),而B组寒颤复发率比A组明显增高(P<0.05)。 A组不良反应发生率比B组明显减少(P<0.05)。结论:静注0.4μg/kg右美托咪定可以快速而有效地治疗全麻术后寒颤,值得临床推广运用。
目的::觀察右美託咪定對全痳下脊柱手術患者術後寒顫的治療作用。方法:選擇全身痳醉下行脊柱手術術後齣現4級全身寒顫的患者60例,隨機分為右美託咪定組( A組)、麯馬多組( B組)及對照組( C組)。噹寒顫持續5 min未自行緩解時,A、B、C 組分彆于5 min內靜脈註射右美託咪定0.4μg/kg、麯馬多1 mg/kg及等量生理鹽水。記錄3組患者給藥前及給藥後1 min、5 min、10 min的血壓、心率、脈搏氧飽和度、寒顫程度及Ramsay鎮靜評分值;記錄A、B兩組患者寒顫治療有效率、起效時間及給藥60 min後的寒顫複髮率;記錄患者頭暈、噁心、嘔吐、呼吸抑製等不良反應髮生率。結果: A組患者在給藥5 min及10 min後Ramsay鎮靜評分值比B組及C組明顯增高(P<0.05)。 A組患者在給藥5 min後寒顫治療有效率比B組明顯高(P<0.01),但在給藥10 min後兩組治療有效率無明顯差異。 A組起效時間比B組明顯縮短(P<0.01),而B組寒顫複髮率比A組明顯增高(P<0.05)。 A組不良反應髮生率比B組明顯減少(P<0.05)。結論:靜註0.4μg/kg右美託咪定可以快速而有效地治療全痳術後寒顫,值得臨床推廣運用。
목적::관찰우미탁미정대전마하척주수술환자술후한전적치료작용。방법:선택전신마취하행척주수술술후출현4급전신한전적환자60례,수궤분위우미탁미정조( A조)、곡마다조( B조)급대조조( C조)。당한전지속5 min미자행완해시,A、B、C 조분별우5 min내정맥주사우미탁미정0.4μg/kg、곡마다1 mg/kg급등량생리염수。기록3조환자급약전급급약후1 min、5 min、10 min적혈압、심솔、맥박양포화도、한전정도급Ramsay진정평분치;기록A、B량조환자한전치료유효솔、기효시간급급약60 min후적한전복발솔;기록환자두훈、악심、구토、호흡억제등불량반응발생솔。결과: A조환자재급약5 min급10 min후Ramsay진정평분치비B조급C조명현증고(P<0.05)。 A조환자재급약5 min후한전치료유효솔비B조명현고(P<0.01),단재급약10 min후량조치료유효솔무명현차이。 A조기효시간비B조명현축단(P<0.01),이B조한전복발솔비A조명현증고(P<0.05)。 A조불량반응발생솔비B조명현감소(P<0.05)。결론:정주0.4μg/kg우미탁미정가이쾌속이유효지치료전마술후한전,치득림상추엄운용。
Objective:To observe the effects of dexmedetomidine on treating postoperative shivering in patients with general an-esthesia undergoing spinal surgery. Methods:Sixty patients with grade 4 of shivering after spinal surgery were assigned randomly into group A,B and C,respectively receiving an intravenous infusion of dexmedetomidine 0. 4μg/kg,tramadol 1 mg/kg,and equivalent nor-mal saline in 5 min. Mean arterial pressure (MAP),heart rate (HR),pulse oxygen saturation (SpO2),grades of shivering and Ramsay sedation scores in three groups were recorded before medication and 1 min,5 min,10 min after medication. The effective rate, onset time,recurrence rate after 60 min and incidence of adverse reaction were also recorded. Results:The Ramsay sedation scores in group A at 5 min and 10 min after medication were higher than that in group B and group C,respectively (P<0. 05). The effective rate in group A at 5 min after medication was higher than that in group B (P<0. 01),but no significant difference was found between the two groups at 10 min after medication. The onset time of group A was shorter than that in group B ( P<0. 01 ) and the recurrence rate in group B was higher than that in group A (P<0. 05). The incidence rate of adverse reaction in group A was lower than that in group B (P<0. 05). Conclusion:Dexmedetomidine 0. 4 μg/kg by intravenous infusion can treat postoperative shivering effectively,which is worthy for clinical application.