不同干预措施对减少全麻苏醒期寒战的对比研究  

A comparison among different interventions in treating shivering during general anesthesia recovery

作　　者：聂玲[1] 魏宏[1] 刘萍[1] 罗晓敏[1] 吕倩茹[1] 

机构地区：[1]广东医学院附属南山医院麻醉科,深圳518052

出　　处：《陕西医学杂志》2014年第1期78-80,共3页Shaanxi Medical Journal

基　　金：深圳市南山区2010年度科技研发资金资助(南科卫2010054号)

摘　　要：目的:探讨不同干预措施对全麻苏醒期寒战的影响。方法:选择100例妇科腹腔镜手术且在苏醒期发生寒战的患者,随机分为四组,每组25例。寒战发生后,A组给予充气式保温毯保暖;B组给予缓慢静脉注射曲马多1mg/kg;C组给予充气式保温毯保暖,缓慢静脉注射曲马多1mg/kg;D组为对照组,给予等量生理盐水静脉注射。观察并记录干预前(T1)、干预后5min(T2)和15min(T3)患者的寒战级别,患者的不良反应(恶心呕吐、头晕等)和返回病房后2h内寒战复发率,以及核心温度(鼓膜温度)的变化。结果:T1时点四组患者寒战程度无显著性差异(P>0.05);T2时点A、B、C组寒战等级低于D组(P<0.05),与A组比较,B、C组寒战疗效更好(P<0.05);T3时点A、B、C组疗效优于D组(P<0.05);A、B、C三组间比较C组疗效最佳(P<0.05)。四组患者各个时间点鼓膜温度无显著性差异(P>0.05)。返回病房后2h内寒战复发率C组明显低于A、B、D组(P<0.05);B、C组不良反应率比较无显著性差异(P>0.05)。结论:充气式保温毯加曲马多,对治疗全麻苏醒期寒战效果显著,不良反应少,且寒战复发率低。Objective： To examine the effects of different interventions on shivering during general anes thesia recovery. Methods： 100 patients scheduled for elective gynecologic laparo scopic operations,were randomly divided into four groups. Group A was received heat protecing blanket after shivering; Group B intravenous injection tramadol lmg/kg;Group C both heat protecing blanket and tramadol; Group D intravenous injection normul suline （as a control group）. Patients were observed in terms of the degree of shivering at times before intervention（Tt ）, 5 minutes （T2）and 15 minutes（Ta ） after interventions. The side effects,core temperature and recurrence rate of shive ring were also observed. Results： At T1 the degree of shivering had no significant differents among four groups. At T2 the degree of shivering in Group A, B, C was significantly lower than that in Group D, and compared with Group A,the degree of shivering in Group B,C was significantly low. At Ta compared with Group D,the degree of shivering in GroupA, B.C was significantly low,and than that in Group C was the lowest . The core temperature during the anesthesia and recovery was similar in all groups. The recurrent rate of shivering in Group C was signifi cantly lower than Group A.B and D within two hours after back to the ward. The adverse effects between Group B and C were similar. Conclusion： Heat protecing blanket and tramadol can effectively treat shivering during general anesthesia recovery, reduce the recurrence rate, of shivering with less adverse reaction.

关 键 词：寒战 药物作用 寒战 治疗 曲马朵 治疗应用 @保温毯保暖 

分 类 号：R614.2[医药卫生—麻醉学]