预泵注甲氧明对剖宫产患者术中寒颤的干预效果  

Effect of Pumping Methoxamine Pre-anesthesia on Preventing Intraoperative Shivering in Cesarean Section Patients

作　　者：王明全[1] 罗春[2] WANG Ming-quan;LUO Chun(Department of Anesthesiology,The First People’s Hospital of Neijiang,Neijiang,SichJ uan,641000,China)

机构地区：[1]内江市第一人民医院麻醉科,四川内江641000 [2]内江市第一人民医院妇产科,四川内江641000

出　　处：《黑龙江医学》2021年第21期2249-2251,共3页Heilongjiang Medical Journal

基　　金：内江市科技计划项目(Z201963)。

摘　　要：目的:评价预泵注甲氧明对剖宫产患者术中寒颤的干预效果。方法:选择于2019年9月—2020年9月间内江市第一人民医院在蛛网膜下腔阻滞麻醉下行剖宫产手术的100例患者,年龄20~40岁,美国麻醉医师协会(ASA)分级为Ⅰ~Ⅱ级,采用随机数字表法分为两组(n=50):麻醉前泵注甲氧明组(泵注组)和麻醉后推注甲氧明组(推注组),两组麻醉前均以10ml/kg/h的速率输注琥珀酰明胶,同时给予静脉注射10mg地塞米松,实施蛛网膜下腔阻滞麻醉平面控制到T6。泵注组在麻醉前给予泵注甲氧明使患者血压维持在其基础血压±20%;推注组麻醉后根据患者血压给予静脉注射甲氧明维持标准同前。记录两组患者术中寒颤发生率及程度,麻醉前后血压心率、甲氧明用量、术中入量、出血、尿量、Apgar评分及恶心呕吐情况。结果:两组患者术中寒颤发生率及寒颤程度差异无统计学意义(P>0.05);泵注组患者麻醉后血压高于推注组,甲氧明用量高于推注组;两组胎儿Apgar评分差异有统计学意义(χ^(2)=2.131,P=0.033);两组患者术中出入量及恶心呕吐差异无统计学意义(P>0.05)。结论:预泵注甲氧明在剖宫产术中不能降低寒颤的发生率,但其术中血流动力学更稳定。Objective:To evaluate the effect of pumping methoxamine pre-anesthesia on preventing intraoperative shivering in cesarean section patients.Methods:A total of 100 patients undergoing cesarean section under subarachnoid block anesthesia in the hospital from September 2019 to September 2020 were selected,aged 20-40 years old,ASAⅠ-Ⅱgrade.They were divided into two groups(n=50)by random number table method:the pre-anaesthesia pump methoxamine group(pump injection group)and postanesthesia bolus injection of methoxamine group(bolus group).Before anesthesia,both groups were infused with succinyl gelatin at a rate of 10 ml/kg/h,and dexamethasone 10 mg was given intravenously.The level of subarachnoid anesthesia was controlled to T6.Pump injection group was given pump injection of methoxamine before anesthesia to maintain the patients’blood pressure at±20%of their basal blood pressure,bolus group was given intravenous injection of methoxamine according to the patients’blood pressure after anesthesia to maintain the same standard as before.The incidence and degree of intraoperative chills,blood pressure and heart rate before and after anesthesia,methoxamine dosage,intraoperative dosage,bleeding,urine volume,Apgar score,and nausea and vomiting were recorded in the two groups of patients.Results:There was no statistically significant difference in the incidence of chills and the degree of chills between the two groups of patients(P>0.05).After anesthesia,the blood pressure of pump injection group was higher than that of bolus group,and the dosage of methoxamine was higher than that of bolus group.The difference in Apgar scores between the two groups was statistically significant(χ^(2)=2.131,P=0.033).There was no statistically significant difference in the amount of input and output,nausea and vomiting between the two groups of patients(P>0.05).Conclusion:The pumping methoxide pre-anesthesia can’t reduce incidence of shivering in in cesarean section patients,but the pressure is more stable in intraoperative.

关 键 词：甲氧明 剖宫产 术中寒颤 

分 类 号：R714[医药卫生—妇产科学]