奈福泮与曲马多预防剖宫产手术寒战的对比研究  

Effect of prophylactic use of nafopam and tramadol on perioperative shivering in cesarean section

作　　者：张治明[1,2] 曾宾[1] 李松林[1] 李洪涛[1] 陈霞[1] 欧阳帆[1] 

机构地区：[1]郴州市第一人民医院(集团)麻醉科,423000 [2]南方医科大学

出　　处：《临床麻醉学杂志》2010年第12期1051-1052,共2页Journal of Clinical Anesthesiology

基　　金：郴州市科委2008GL12

摘　　要：目的比较奈福泮和曲马多对预防剖宫产手术中寒战的效果。方法拟在腰-硬联合麻醉下进行剖宫产手术的产妇210例,ASAⅠ或Ⅱ级,年龄20～35岁,体重50～75kg,随机分为三组:分别在麻醉开始前肌注奈福泮20mg(N组),曲马多100mg(T组),生理盐水2ml(C组),每组70例。记录出现寒战的例数并对寒战强度进行评估。若患者在手术中出现Ⅱ级以上寒战,则随机静脉追加曲马多50mg(At组)或奈福泮10mg(An组),观察注药后的并发症及寒战的缓解情况。用VAS对患者恶心呕吐进行评分。结果 N组和T组术中出现寒战例数明显少于C组(P<0.05),N组少于T组(P<0.05)。产妇在追加曲马多或奈福泮5min后寒战均能缓解,但At组恶心、呕吐为中重度的例数多于An组(P<0.05),发生静脉注射痛的例数明显少于An组(P<0.05)。结论奈福泮和曲马多均能有效预防剖宫产手术寒战的发生,但奈福泮的效果更好。两种药物能对已经发生的寒战有良好的治疗作用。在治疗寒战时,曲马多更容易引起恶心呕吐,而奈福泮则可引起静脉注射痛。Objective To compare the effect of nafopam and tramaldol on shivering during cesarean section.Methods Two hundred and ten ASA ⅠorⅡpatients （20-35 years old,50-57 kg）scheduled for cesarean section were divided randomly into three groups with 70 each. They received 20mg nafopam （N group）,100mg tramadol （T group） or 2 ml normal saline（C group） intramuscularly before anesthesia. The incidence and magnitude of shivering were recorded. Additional 10mg nafopam （At group） or 50mg tramadol （An group） were injected if the magnitude of shivering was greater than grade Ⅱ. Nausea and vomiting was also scored by Visual Analog Score （VAS）.Results The shivering cases in group C were significantly more than those in group N and T（P0.05） and it was more significant in group N. Shivering can be treated effectively by 10 mg nafopam or 50 mg tramadol. Nausea and vomiting was significant in At group but injection pain was significant in An group（P0.05）.Conclusion Prophylactic use of nafopam or tramadol can be effective in preventing and treating shivering in cesarean section.

关 键 词：奈福泮 曲马多 寒战 剖宫产术 

分 类 号：R614[医药卫生—麻醉学]