曲马多治疗硬膜外阻滞后寒战的临床观察

A clinical observation on Tramadol in the treatment of chill after Epidural Anesthesia

目的:观察曲马多对硬膜外腔阻滞后寒战的冶疗效果及不良反应。方法:将在硬膜外腔阻滞下行腹部手术的病人ASA Ⅰ～Ⅱ级100例随机分为两组,每组50例,曲马多组(Ⅰ组)经静脉注射1%曲马多(用生理盐水稀释)1mg/kg;哌替啶组(Ⅱ组)经静脉注射1%哌替啶0.75mg/kg。两组注药部位均为上肢静脉,注药速度均为30mL/min,若注药5min后寒战仍未消失者再经静脉加注咪唑安定0.05mg/kg。观察两组病人的治疗效果和不良反应。结果:两组病人一般情况(性别、年龄、身体指数)、手术部位、静脉给药部位及手术开始前输液速度均无显著性差异(p>0.05),两组注药前寒战的分级与注药后1min、5min治疗效果的判定均无显著性差异(p>0.05),但注药后3min治疗效果的判定Ⅰ组优于Ⅱ组,组间有显著性差异(p<0.05),而Ⅰ组不良反应明显低于Ⅱ组,组间有极显著性差异(p<0.01)。结论:曲马多治疗硬膜外腔阻滞后寒战效果确切,不良反应少,优于哌替啶,是一种理想的冶疗硬膜外阻滞后并发症寒战的药物。

Objective:To observe the clinical effect of tramadol in the treatment of chill after epidural anesthesia.Methods: 100 patients under going epidural anesthesia were divided into two groups randomly,50 patients in tramadol group( Ⅰ) were injected intravenously with 1% tramadol(diluted with normal saline) lmg/kg.50 patients in pethidine group(Ⅱ) were injected intravenously with 1% pethidine(diluted with normal saline)0.75mg/kg.The speed of the two injection was 30mL/min,After five minutes the patients who were still chilling were injected with midazolam 0.05mg/kg.Observe the effect and ADRs after one minute,three minutes and five minutes.Results: After one minute and five minutes the effect has no statistically difference(p>0.05).However,after three minutes the effect of the tramadol group was obviously superior to that of the pethidine group(p<0.05),and the complications of tramadol group were also less than pethidine group(p<0.01).Conelusions: Tramadol displayed good effect in treatment of the chill after epidural anesthesia.