哌替啶复合氟哌啶预处理对腰麻后寒颤的影响  

Clinical observation of piperidine complex fluoropiperidine pretreatment on chills after spinal anesthesia

作　　者：戚志超[1] 吴论[1] 朱小兵[1] 陈浩[1] 

机构地区：[1]广州中医药大学中山附属医院,广东省中山市528400

出　　处：《临床合理用药杂志》2017年第31期15-17,共3页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察哌替啶复合氟哌啶预处理对腰麻后寒颤反应的预防效果。方法选择腰硬联合麻醉下施行手术的下肢骨折患者150例,ASAⅠ~Ⅱ级,随机分为3组,每组50例,A组静脉注射哌替啶0.5 mg/kg和氟哌啶0.025 mg/kg;B组静脉注射哌替啶1 mg/kg和氟哌啶0.05 mg/kg;C组静脉注射同等容量的生理盐水。观察3组寒颤反应发生率及程度,同时记录用药后3组患者头晕、嗜睡、恶心呕吐、锥体外系反应等不良反应的发生情况。记录3组患者的心率(HR)及血氧饱和度(Sp O2)。结果 A组、B组和C组患者寒颤的发生率分别为14%、8%和54%,C组寒颤的发生率明显高于A、B两组,差异均有统计学意义(P<0.05),而A组与B组寒颤的发生率比较差异无统计学意义(P>0.05)。B组头晕、嗜睡、恶心呕吐等不良反应的发生率明显高于A、C两组,差异有统计学意义(P<0.05),而A组与C组不良反应发生率比较差异无显著性(P>0.05)。3组患者的MAP组内、组间比较差异无显著性(P>0.05);用药后1 min、5 min和10 min B组患者的HR明显增快,而且也明显比A、C两组快,差异均有统计学意义(P<0.05),15 min后组内组间HR比较差异无显著性(P>0.05)。结论哌替啶复合氟哌啶预处理对预防腰麻后寒颤反应效果明显;而且以哌替啶0.5 mg/kg复合氟哌啶0.025 mg/kg效果更优。Objective To investigate the effects of piperidine complex fluoropiperidine pretreatment on chills after spinal anesthesia. Methods 51 patients with lower extremity fractures underwent surgery under combined spinal-epidural anesthesia,ASA Ⅰ ~ Ⅱ,were randomly divided into 3 groups,each of 50 cases. Group A was given intravenous pethidine0. 5 mg/kg and haloperidol 0. 025 mg/kg. Group B was given intravenous pethidine 1 mg/kg and haloperidol 0. 05 mg/kg;Group C was given intravenous saline of equal volume. The incidence and severity of the chills were observed. The incidence of adverse reactions such as dizziness,drowsiness,nausea and vomiting,and extrapyramidal reactions were recorded. The blood heart rate（ HR） and blood oxygen saturation（ Sp O2） were recorded in three groups. Results The incidence of chills in group A,group B and group C was 14%,8% and 54%,respectively. The incidence of chills in group C was significantly higher than that in group A and group B,the differences were statistically significant（ P 〈 0. 05）. There was no significant difference in the incidence of chills between group A and group B（ P 〈 0. 05）. The incidence of adverse reactions such as dizziness,drowsiness,nausea and vomiting in group B was significantly higher than that in group A and group C,the differences were statistically significant（ P 〈 0. 05）. There was no significant difference in the incidence of adverse reactions between group A and group C（ P 〈 0. 05）. There was no significant difference in MAP between three groups（ P 〈 0. 05）. There was no significant difference in MAP between three groups（ P 〈 0. 05）. The HR of patients in group B was significantly faster than that in group A and group C at 1 min,5 min and 10 min after treatment,and the difference was statistically significant（ P 〈 0. 05）. There was no significant difference of HR 15 min after（ P 〈 0. 05）. Conclusion Intravenous pethidine and droperidol before spinal anesthesia is effective to control shivering,

关 键 词：哌替啶 氟哌啶 寒颤 麻醉 

分 类 号：R614[医药卫生—麻醉学]