鞘内注射小剂量哌替啶对剖宫产术中寒战的影响  

The effect of intrathecal low doses of meperidine on shivering during cesarean delivery

作　　者：王同春[1] 黄蓉华[2] 罗勇[1] 严达红 彭新帆[1] 

机构地区：[1]广东省中山市陈星海医院麻醉科,528415 [2]广东省中山市陈星海医院妇产科,528415

出　　处：《中国医师进修杂志》2013年第36期1-3,共3页Chinese Journal of Postgraduates of Medicine

基　　金：广东省中山市卫生局科研基金（J2012277）

摘　　要：目的观察鞘内注射不同剂量的哌替啶对剖宫产患者寒战的影响。方法60例ASA分级Ⅰ～Ⅱ级剖宫产患者按随机数字表法分为四组，每组15例，均采用蛛网膜下隙联合硬膜外麻醉（腰硬联合麻醉）。A组蛛网膜下隙麻醉药为0．5％布比卡因10mg；B组蛛网膜下隙麻醉药为0．5％布比卡因10mg＋5％哌替啶5mg；C组蛛网膜下隙麻醉药为0．5％布比卡因10mg＋5％哌替啶10mg；D组蛛网膜下隙麻醉药为0．5％布比卡因10mg＋5％哌替啶15mg。分别于麻醉后10、20、30、60min记录寒战发生例数与级别、生命体征（血压、心率、体温、呼吸频率、脉搏血氧饱和度），恶心呕吐发生情况，胎儿取出后1、5rainApgar评分。结果所有患者均顺利完成手术，未出现意外。四组各时间点生命体征、恶心呕吐发生例数及新生儿1、5minApgar评分比较差异均无统计学意义（P〉0．05）。A组寒战发生例数明显多于B、C、D组（11例比2、1、1例），差异有统计学意义（P〈0．01）；A组3级寒战发生例数明显多于B、C、D组（4例比0、0、0例），差异有统计学意义（P〈0．01）。结论腰硬联合麻醉时鞘内注射哌替啶5～15mg能有效防止剖宫产术中寒战的发生。Objective To investigate the effect of different intrathecal doses of meperidine on shivering during cesarean delivery under spinal-epidural anesthesia. Methods Sixty parturient women, ASA grade I - II grade, scheduled for cesarean delivery were enrolled in four groups by random digits table with 15 cases each group. All patients underwent combined spinal-epidural anesthesia. Spinal anesthesia consisted of isobaric bupivacaine 0.5% （ 10 mg） in the standard group （group A）, isobaric bupivacaine 0.5% （10 mg） plus 5 mg meperidine in group B,isobaric bupivacaine 0.5%（10 mg） plus 10 mg meperidine in group C,isobaric bupivacaine 0.5%（ 10 mg） plus 15 mg meperidine in group D. The signs and symptoms were recorded 10,20,30,60 min after anesthesia respectively. Results All patients were successfully operated, not unexpected. Four groups at each time point of vital signs, nausea and vomiting, and the number of cases of neonatal 1,5 min Apgar scores was no significant difference （P 〉 0.05）. Group A of shivering and the third grade shivering were significantly more than the number of group B, C, D（ 11 cases vs. 2, 1,1 cases;4 cases vs. 0,0,0 cases,P〈 0.01）. Conclusion Epidural anesthesia,intrathecal meperidine 5 - 15 mg can effectively prevent shivering in cesarean section.

关 键 词：寒战 哌替啶 剖宫产术 

分 类 号：R614[医药卫生—麻醉学]