格拉斯琼预防全麻后寒战的临床观察  

Efficacy of Granisetron in Preventing Postanesthetic 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10期2540-2542,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ASAI～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1mg/kg),G组(格拉斯琼40μg/kg),M组(哌替啶0.4mg/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±4.13min)较对照组(12.61±3.31min)和格拉斯琼组(13.58±3.41min)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0.4mg/kg一样可有效地预防麻醉后寒战。Objective：To evaluate the efficacy of granisetron in comparison with meperidine and tramadol in preventing postanesthetic shivering.Methods：120 ASA I and II patients undergoing elective surgery under standardized general anesthesia were included.At the end of surgery,patients were randomly assigned to one of four groups （each group n = 30） using a double-blinded protocol.Group T received 1 mg/kg tramadol,group G received 40 μg/kg granisetron （an antiemetic dose）,group M received 0.4 mg/kg meperidine,and group P received saline 0.9% as placebo.Shivering was graded according to the following：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 entire body.The emergence time from anesthesia,defined as the time between withdrawal of isoflurane and tracheal extubation,was documented.Results：The number of patients with observable shivering was 19 in group P,nine in group G,seven in group T and six in group M.Granisetron significantly reduced the incidence of shivering in comparison with placebo （P=0.013）.Although the frequency of shivering was higher with granisetron in comparison to tramadol and meperidine,it was not statistically significant （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）.Both meperidine and tramadol caused a significantly prolonged emergence time （20.58 ± 3.56 and 16.45 ± 4.13 minutes,respectively） as opposed to granisetron （13.58 ± 3.41 minutes） and placebo （12.61 ± 3.31 minutes）.Conclusion：The prophylactic use of granisetron 40 μg/kg is as effective as meperidine （0.4 mg/kg） and tramadol （0.1 mg/kg） in preventing postanesthetic shivering without prolonging the emergence time from anesthesia

关 键 词：格拉斯琼 曲马多 格拉斯琼 寒战 

分 类 号：R614.2[医药卫生—麻醉学]