右美托咪定与曲马多在下肢手术中预防寒战及镇静程度的比较  

Comparison between dexmedetomidine and tramadol in chill prevention and sedative degree during lower extremity operation

作　　者：周毛[1] 彭玉璇[1] 许冬妮[1] 叶西就[1] 

机构地区：[1]中山大学孙逸仙纪念医院麻醉科,广州510120

出　　处：《岭南现代临床外科》2015年第1期63-66,共4页Lingnan Modern Clinics in Surgery

基　　金：国家自然科学基金面上项目(30972547)

摘　　要：目的比较右美托咪定与曲马多在防治腰硬联合麻醉下行下肢手术术中寒战的发生率及镇静程度。方法选择ASAⅠ-Ⅱ级择期经腰硬联合麻醉行下肢手术患者60例,随机分成3组：右美托咪定组（D组）采用静脉推注0.5μg/kg的右美托咪定）,曲马多组（T组）静脉推注2mg/kg的曲马多,空白对照组（C组）静脉推注等量生理盐水,3组均在实施腰硬联合麻醉前10min内给完所需药量,比较三组患者血流动力学的变化、寒战的发生率及镇静评分。结果与C组比较,D组和T组均能降低患者寒战的发生率,差异有统计学意义（P〈0.05）;与T组比较,D组使用的右美托咪定能提高患者的镇静评分,且无恶心呕吐等不良反应的发生。结论右美托咪定与曲马多在腰硬联合麻醉前静脉泵注,能够有效降低寒战反应发生率,右美托咪定更能提高患者的镇静满意度,且无药物不良反应发生。Objective To investigate the effect of dexmedetomidine and tramadol on preventing shivering in patients during spinal and epidural anesthesia. Methods Sixty ASA Ⅰ-Ⅱpatients undergoing selective lower extremity operation under spinal and epidural anesthesia were randomized into three groups.Twenty patients were randomized group D：..intravenous injection of dexmedetomidine 0.5 μg / kg preoperatively,.group T：.intravenous injection of Tramadol 2 mg / kg preoperatively,.and group C ：.intravenous saline 0.9% injection of the same dose..The changes of vital signs after injection were recorded.The occurrence of shivering and Ramsay sedation score.（RSS）were observed. Results Group D and Group T had a lower shivering incidence than the group C.The difference was statistically significant（P〈0.05）. The Ramsey sedation score（RSS） was higher in group D than in group T after injection（P〈0.05） and the side effect rate in group D was lower than that in group T. Conclusion Dexmedetomidine and tramadol may be effective in preventing shivering during spinal and epidural anesthesia...The former showed more results in reducing the incidence of side effects and increasing the Ramsay sedation score.

关 键 词：右美托咪定 曲马多 腰硬联合麻醉 寒战反应 

分 类 号：R614.4[医药卫生—麻醉学]