盐酸右美托咪定对剖宫产患者椎管内麻醉期间寒战反应的预防效果探究  

Study on Effect of Dexmetomidine Hydrochloride in Preventing the Chill Reactions of Patients with Cesarean Section during the Intravertebral Anesthesia Period

作　　者：王昊 WANG Hao(Department of Anesthesia,Linfen Central Hospital Linfen Fourth People’s Hospital,Linfen,Shanxi Province,041000 China)

机构地区：[1]山西省临汾市中心医院(临汾市第四人民医院)麻醉科,山西临汾041000

出　　处：《中外医疗》2017年第35期155-158,共4页China & Foreign Medical Treatment

摘　　要：目的探讨盐酸右旋美托咪啶(Dexmedetomidine,DEX)对剖宫产(Caesarean section,CS)患者椎管内麻醉期间寒战反应的预防效果。方法方便选择2013年12月—2015年3月在该院接受剖宫产手术并行椎管内麻醉的患者96例,随机分成观察组48例和对照组48例,观察组患者在胎儿剖出后采用静脉注射DEX,而对照组同样方法注射0.9%氯化钠溶液。在给药前和给药后30 min统计两组患者的心率(HR)、平均动脉压(Mean arterial pressure,MAP)和Ramsay镇静评分,并比较两组患者寒战反应及不良反应发生情况。结果两组用药前的HR、MAP和Ramsay评分相比,差异无统计学意义(P>0.05);给药30 min时,观察组患者的HR、MAP明显低于对照组[(72.6±7.7)bpm vs(82.1±5.4)bpm,(60.9±8.1)mm Hg vs(75.3±9.4)mm Hg](P<0.05),而Ramsay评分明显高于对照组[(2.82±0.17)分vs(2.06±0.10)分];观察组寒战发生率为10.4%(5/48),对照组为27.1%(13/48),两组相比差异有统计学意义(P<0.05);观察组不良反应率为8.3%(4/48),对照组为25.0%(12/48),两组相比差异有统计学意义(P<0.05)。结论 CS患者胎儿剖出后泵入DEX对椎管内麻醉期间寒战反应的发生具有明显的预防效果,值得在临床上进一步推广。Objective To study the effect of dexmetomidine hydrochloride in preventing the chill reactions of patients with cesarean section during the intravertebral anesthesia period.Methods 96 cases of patients with cesarean section during the intravertebral anesthesia period in our hospital from December 2013 to March 2015 were conveniently selected and randomly divided into two groups with 48 cases in each,the observation group adopted the intravenous injection of DEX after the cesarean section,while the control group were injected with 0.9%sodium chloride solution in the same method,and the heart rate,MAP and Ramsay score of the two groups in 30min before and after administration were counted,and the chill reactions and occurrence of adverse reactions were compared between the two groups.Results The differences in the HR,MAP and Ramsay score between the two groups before medication were not statistically significant(P>0.05),at 30min of administration,the HR and MAP in the observation group were obviously lower than those in the control group[(72.6±7.7)bpm vs(82.1±5.4)bpm,(60.9±8.1)mmHg vs(75.3±9.4)mmHg](P<0.05),but the Ramsay score was obviously higher than that in the control group[(2.82±0.17)vs(2.06±0.10)],and the incidence rate o f chills in the observation group and in the control group was respectively 10.4%(5/48)and 27.1%(13/48),and the difference was statistically significant(P<0.05),and the ad verse reaction rate in the observation group and in the control group was respectively 8.3%(4/48)and 25.0%(1248),and the difference wa statistically significant(P<0.05).Conclusion The pumping of DEX for CS patients after cesarean section has an obvious effect on reducing the occurrence of chill reactions during the Intravertebral anesthesia period,and it is worth further promotion in clinic.

关 键 词：右旋美托咪啶 剖宫产 寒战反应 RAMSAY镇静评分 

分 类 号：R614[医药卫生—麻醉学]