蛛网膜下腔注射曲马多对预防剖宫产患者术中寒战的观察  

Clinical observation on the preventive effect against patient's shivering during casearean section by injecting tramadol into the subarachnoid space

作　　者：刘冀湘[1] 伍堂洪[2] 蒋庆方[2] 

机构地区：[1]广东省东莞市太平人民医院麻醉科,523900 [2]遵义医学院第五附属医院麻醉科

出　　处：《河北医药》2006年第4期266-267,共2页Hebei Medical Journal

摘　　要：目的观察蛛网膜下腔注射曲马多预防剖宫产患者术中寒战的效果.方法选择剖宫产手术患者80例,ASA分级Ⅰ～Ⅱ级,随机分成对照组（A组）和曲马多组（B组）,每组40例.腰硬联合麻醉,40s内匀速向蛛网膜下腔注入药液.A组：0.5%布比卡因1.8ml,B组：0.5%布比卡因1.8ml＋曲马多0.3～0.4mg/kg,观察术中寒战分级、恶心呕吐发生率.结果B组术中寒战发生率较A组低（P＜0.01）,同时,寒战程度也较轻.B组术中恶心呕吐发生率为90%,较A组高（P＜0.01）.结论小剂量曲马多（0.3～0.4mg/kg）注入蛛网膜下腔可以用于腰麻下剖宫产术中寒战的预防,但增加恶心呕吐的发生率.Objective To observe the preventive effect against patient＇s shivering during caesarean section by injecting tramadol into the subarachnoid space.Methods Eighty ASA Ⅰ-Ⅱ patients （age range 21 - 29 yr）, weighting 65 - 85 kg who received the casesarean section. The patients were divided into 2 groups randomly （ n = 40 each） ,group A （control group） and group B（tramadol group）. Using the combined spinal and epdural anesthesia （SCEA）, and choosing L3-4 as the dural puncture pot. After successful dural puncture, the different medicines were injected： group A with 0.5% bupivacaine 1.8 ml and group B with 0.5% bupivacaine 1.8 ml mixed tramadol 0.3 - 0. 4 mg/kg injected into the subarachnoid space, the incidences of shivering, nausea and vomiting were observed. Results The incidence and the degree of shivering in group B were less and lighter than that in group A （ P 〈 0. 01 ）. The incidence of nausea and vomiting in group B （90%） was significantly higher than that of group A （ P 〈 0.01 ）. Conclusion Low-dose tramadol （0.3 - 0. 4 mg/kg） administered in subarachnoid space during caesarean section may prevent the occurrence of shivering, however, the complication of nausea and vomiting may increase comparatively.

关 键 词：曲马多 蛛网膜下腔 剖宫产 寒战 

分 类 号：R719.8[医药卫生—妇产科学] R473.6[医药卫生—临床医学]