曲马多联合昂丹司琼预防剖宫产麻醉后寒颤的效果观察  

Clinical effect observation of tramadol combined with ondansetron on prophylaxis of shivering after cesarean section anaesthesia

作　　者：侯杰[1] 王淑伟[1] 罗美怡 邱弛宇 李景云[1] 

机构地区：[1]广东省深圳市坪山新区人民医院麻醉科,518118

出　　处：《临床合理用药杂志》2015年第13期18-19,共2页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察曲马多联合昂丹司琼预防蛛网膜下腔麻醉后寒颤的临床效果。方法将120例行剖宫产的产妇随机分为观察组A、观察组B和对照组。麻醉开始前,观察组A缓慢静脉注射曲马多1mg/kg,观察组B缓慢静脉注射曲马多1mg/kg+昂丹司琼4mg,对照组给予生理盐水4ml。观察麻醉开始至手术结束4h内产妇寒颤、恶心呕吐、眩晕、低血压、呼吸抑制等不良反应情况和新生儿Apgar评分情况。结果观察组A和观察组B产妇寒颤发生率均低于对照组,差异均有统计学意义(P<0.05),观察组A恶心呕吐发生率高于观察组B和对照组,差异均有统计学意义(P<0.05),观察组B与对照组恶心呕吐发生率差异无统计学意义(P>0.05)。3组均未发生眩晕、呼吸抑制等,且术中低血压发生率3组间差异无统计学意义(P>0.05),3组新生儿Apgar评分组间差异无统计学意义(P>0.05)。结论曲马多联合昂丹司琼能有效预防蛛网膜下腔麻醉后的寒颤反应,且恶心呕吐的发生率较低。Objective To observe the clinical effect of tramadol with ondansetron on prophylaxis of shivering during spinal anaesthesia. Methods 120 patients undergoing cesarean section were randomly divided into the observation group A,observation group B and control group. Before the start of anesthesia,the observation group A was given slow intravenous injection with tramadol 1 mg / kg,and the observation group B was given slow intravenous injection with tramadol 1 mg / kg and ondansetron 4 mg,and the control group was given normal saline 4ml. From the start of anesthesia to the end of the operation,the chills,nausea and vomiting,dizziness,hypotension,respiratory depression and other adverse reaction and neonatal Apgar score of the three groups were observed. Results The incidence of shivering of observation group A and group B were lower than control group（ P 0. 05）. The incidence of nausea and vomiting of observation group A was higher than the observation group B and control groupt（ P 0. 05）. The difference of incidence of nausea and vomiting between the observation group B and control group was not statistically significant（ P 0. 05）. There were no statistically significant difference between the 3 groups incidence of intraoperative hypotension and neonatal Apgar score group（ P 0. 05）. Conclusion Compared with tramadol 1 mg /kg,tramadol 1 mg / kg combined with ondansetron 4 mg can effectively prevent shivering after anesthesia,and the incidence of nausea and vomiting was low.

关 键 词：曲马多 昂丹司琼 预防 剖宫产 麻醉 寒颤 恶心呕吐 

分 类 号：R614[医药卫生—麻醉学]