格拉斯琼预防全麻后寒战的临床观察  

Efficacy of Granisetron in Preventing Postanesthesia Shivering

作　　者：张永洪[1] 杨天凤[1] 唐晓凤[1] 

机构地区：[1]四川省绵阳市中心医院麻醉科,四川绵阳621000

出　　处：《华西医学》2009年第9期2299-2301,共3页West China Medical Journal

摘　　要：目的:探讨同哌替啶和曲马多比较,格拉斯琼预防全麻后寒战的临床效果。方法:120例ASA I^II级,在全麻下拟行择期手术患者,随机分为四组,每组30例:T组(曲马多1 mg/kg),G组(格拉斯琼40μg/kg),M组(哌替啶0.4 mg/kg)和P组(0.9%生理盐水)。各组药物在手术结束时通过静脉给予。记录术后寒战评分和麻醉恢复时间及镇静程度。结果:同对照组比较,格拉斯琼明显减少麻醉后寒战的发生(P<0.01),但同哌替啶和曲马多组比较无统计学差异(P>0.05)。哌替啶组和曲马多组的麻醉恢复时间(20.58±3.56和16.45±4.13 min)较对照组(12.61±3.31 min)和格拉斯琼组(13.58±3.41 min)明显延长(P<0.05)。结论:使用40μg/kg格拉司琼同使用曲马多1mg/kg和哌替啶0.4 mg/kg一样可有效地预防麻醉后寒战。Objective：To evaluate the efficacy of granisetron on the incidence of postanesthesia shivering in comparison with meperidine and tramadol.Methods：120 ASA I and II patients undergoing elective surgeries with standardized general anesthesia were randomly divided into four groups with 30 patients in each group using a double-blinded protocol：1mg/kg tramadol（group T）,40 μg/kg（an antiemetic dose） of granisetron（group G）,0.4mg/kg meperidine（group M）,and saline 0.9% as placebo（group P）.Shivering was graded according to the followings：0 = no shivering;1 = piloerection,peripheral vasoconstriction or peripheral cyanosis without other cause;2 = visible muscular activity confined to one muscle group;3 = visible muscular activity in more than one muscle group;and 4 = gross muscular activity involving the whole body.The emergence time,defined as the time from termination of isoflurane to tracheal extubation wasrecorded.Results：The number of patients with observable shivering was 19 in group P,9 in group G,7in group T and 6 in group M.The incidence of shivering in group G was significantly reduced in comparison with group P（p = 0.013）.Although the frequency of shivering in group G was higher than that in group T and M,,it did not reach to statistically difference（p〉 0.05）.The number of patients with a shivering score of 2,3 and 4 was significantly higher in group P compared with the other groups（p = 0.001）.The emergence time in group T and M was significantly prolonged（20.58 ± 3.56 and 16.45 ± 4.13 minutes,respectively） compared with group G（13.58 ± 3.41 minutes） and P（12.61 ± 3.31 minutes）.Conclusion：The prophylactic administration of granisetron 40 μg/kg is as effective as pretreatment of meperidine（0.4mg/kg） and tramadol（0.1mg/kg） in preventing postanesthesia shivering without prolonging the emergence time.

关 键 词：格拉斯琼 曲马多 寒战 

分 类 号：R614.2[医药卫生—麻醉学]