曲马多复合静安预防妇科宫颈癌根治术在硬膜外麻醉期间寒颤反应的临床观察  

Effects of Tramadol Compound Jingan and Pethidine Prevented Gynecology Department Cervical Cancer Root Governing Skill on Controlling of Shivering During Operation Under Epiduial Cervicalral Anaesthesia Period

作　　者：陈龙水[1] 

机构地区：[1]汕头大学医学院第一附属医院麻醉科,广东汕头515041

出　　处：《河北医学》2008年第5期518-521,共4页Hebei Medicine

摘　　要：目的：观察曲马多复合静安预防妇科宫颈癌根治术在硬膜外麻醉期间寒战反应的临床表现。方法：选择120例准备在硬膜外麻醉下行宫颈癌根治术成年患者，随机分为3组：A组（曲马多复合静安组），B组（哌替啶组），C组（对照组）。三组均于硬膜外注药前5min分别静注：曲马多1．5mg／kg，开始手术时静脉持续输注静安1～2mg／kg／h（A组），哌替啶1mg／kg（B组），同等容量的生理盐水（C组）。观察麻醉及手术过程中寒战的发生率，寒战的严重程度及术前、术中、术后的体温、平均动脉压（MAP）、心率（HR）、血氧饱和度（SPO2）的变化。结果：A组、B组、C组寒战发生率为5．0％，10．0％和30．0％；C组分别与A、B组比较，差异有统计学意义（P〈0．01）；3组患者术前、术中、术后的体温、MAP、HR、SPO2组间和组内对比，差异均无统计学意义（P〉0．05）；不起反应发生率，B组较高，与A、C组比较，差异有统计学意义（P〈0．01）。结论：术前静注曲马多复合术前术中静脉输注静安有助于预防犬手术长时间硬膜外麻醉期间的寒战反应，其中曲马多复合静安的效果优于哌替啶,特别是静脉输注曲马多复合静安能有效的预防犬手术长时间硬膜外麻醉期间局麻药的毒性反应。Objective .To observe the effect were of tramadol compound jingan and skill on controlling of shivering during operation under epidural anaesthesia period. Method： 120 adult patients who were to under go Gynecology department cervical cancer root governing skill on controlling of shivering during surgery were randomly divided into 3groups：Group A ,in which patients received dintra intravenous injection of tramadol （1.5mg/kg） 5 minutes before epidural anaesthesia, and The vein continues the infusion for jingan （1-2mg/kg·min） at starting surgery time. Group B, pethidine （1 mg/kg） were given at the same time point ; and Group C ,normal saline of the same volume. The incidence rate of shivering during operation was observed and body temperature , mean arterial pressure （ MAP ）, heart rate （ HR ） and arterial oxygen saturation （SPO2） were determined before, during and after operation. Result： The incidence rate of shivering was 5. 0% , 10.0% and 30.0% in three groups ,respectively, and there was statistically significant difference between group C and group A or B（P〈0.01）. No differences were found in body temperature ,MAP ,HR, and SPO2 before, during or after operation with in each group or between groups （P〉0.05）. Patients in group B had more side effects than the others （P〈0.01）. Conclusion：Intravenous injection of tramadol compound jingan or pethidine beforee piduralis effective to control shivering ,in which tramadol compound jingan has a better result than pethidine, special to long time surgery and major surgery prevent for local anesthetic toxic response.

关 键 词：寒颤 麻醉 曲马多 静安哌替啶 

分 类 号：R614[医药卫生—麻醉学]