加温碘伏消毒联合布托啡诺对腰-硬联合麻醉剖宫产产妇寒战的影响  

Effect of heated iodophor with Butorphanol Tartrate for prevention of shivering in patients during cesarean section under combined spinal and epidural anesthesia

作　　者：解立杰 孙敏[1] 姚光[1] 王建营[1] 宋立娟 张全意[1] XIE Li-jie;SUN Min;YAO Guang(Deparment of Anesthesiology,Affiliated Hospital of Binzhou Medical University,Binzhou 256603,China)

机构地区：[1]滨州医学院附属医院麻醉科,山东滨州256603

出　　处：《吉林医学》2023年第7期1874-1877,共4页Jilin Medical Journal

基　　金：山东省省级临床重点专科学科建设项目[项目编号:SLCZDZK-20];山东省教育厅临床医学+X学科建设项目[项目编号:200375]。

摘　　要：目的:探讨加温碘伏消毒联合布托啡诺用于预防腰-硬联合麻醉剖宫产产妇寒战的效果。方法:选取拟在腰-硬联合麻醉下行剖宫产单胎、足月妊娠产妇200例为研究对象,年龄20-35岁,体重50-80 kg,ASAⅠ级或Ⅱ级。随机分为A组、B组、C组、D组各50例,A组:常温碘伏+生理盐水;B组:常温碘伏+布托啡诺;C组:加温碘伏+生理盐水;D组:加温碘伏+布托啡诺。A组与B组患者椎管内穿刺及术野消毒采用常温碘伏,C组与D组患者采用加温碘伏消毒。胎儿娩出后夹毕脐带即刻,B组、D组产妇分别静脉注射布托啡诺1 mg,A组、C组静脉注射等容量生理盐水。采用Wrench寒战分级评价给药后至手术结束时寒战的发生情况,记录给药前和给药15 min后的Ramsay镇静评分,记录给药后至手术结束时过度镇静、恶心呕吐、低血压及牵拉反应的发生情况。结果:与A组比较,B组、C组、D组寒战发生率明显降低,差异有统计学意义(P<0.05);与B组、C组比较,D组寒战发生率明显降低,差异有统计学意义(P<0.05);与A组比较,B组给药后15 min后Ramsay镇静评分增高,差异有统计学意义(P<0.05);与C组比较,D组给药后15 min后Ramsay镇静评分增高,差异有统计学意义(P<0.05);与C组比较,D组恶心呕吐、低血压、眩晕等不良反应差异无统计学意义(P>0.05),牵拉反应明显降低,与A组比较,B组牵拉反应明显降低。结论:加温碘伏联合布托啡诺比单纯布托啡诺或单纯加温碘伏更能够安全、有效地预防剖宫产寒战的发生,且镇静效果良好。Objective To explore the effect of heated iodophor with Butorphanol Tartrate forprevention of shivering in patients during cesarean section under combined spinal and epidural anesthesia.Method A total of 200 patients,aged 20-35 years,weighting 50-80 kg,ASA physical status Ⅰ or Ⅱ,were selected as the research subjects and randomly divided into 4 groups(50 cases in each group):group A,group B,group C,group D.Patients in group A and group B were sterilized by room temperature iodophor during spinal and epidural anesthesia and operation,and patients in group C and group D were sterilized by heated temperature iodophor.After delivery,the patients in groups A and C were received an intravenous infusion 1 mg butorphanol tartrate immediately before clamping the umbilical cord,and the equal volume of normal saline were given instead in groups B and D.The development of shivering was recorded from the end of butorphanol tartrate administration to the end of surgery,and the shivering intensity was estimated using Wrench grading.Ramsay sedation score was recorded 15 minutes before giving butorphanol tartrate and 15minutes after giving butorphanol tartrate.The incidence of over-sedation,nausea and vomiting,hypotension,traction reaction were recorded from the end of butorphanol tartrate administration to the end of surgery.Results Compared with group A,the incidence of shivering were decreased in groups B,C,and D(P<0.05).Compared with group B and C,the incidence of shivering were decreased in group D(P<0.05).Compared with group A,the Ramsay sedation score was significantly increased at 15 minutes after giving butorphanol tartrate in group B(P<0.05).Compared with group C,the Ramsay sedation score was significantly increased at 15 minutes after giving butorphanol tartrate in group D(P<0.05).Compared with group C,there was no significant difference in nausea,vomiting,Hypotension,dizziness and other adverse reactions in group D(P>0.05),the incidence of traction reaction was significantly decreased in group D(P<0.05).Compared w

关 键 词：加温碘伏 布托啡诺 剖宫产 寒战 腰硬联合麻醉 

分 类 号：R614[医药卫生—麻醉学]