麻醉前静注长托宁预防剖宫产围术期寒颤的临床研究

THE CLINICAL RESEARCH OF PENEHYCLIDINE HYDROCHLORIDE INJECTED BEFORE ANESTHESIA TO PREVENT THE PERIOPERATIVE SHIVERING OF CESAREAN SECTION

目的探讨麻醉前预防性静注长托宁对剖宫产围术期寒颤的作用。方法80例择期在腰硬联合麻醉下行剖宫产的产妇，ASAⅠ-Ⅱ级，随机分为两组，每组产妇均为40例。术前Ⅰ组静脉注射长托宁1mg，Ⅱ组静脉注射0．5mg阿托品。持续监测围术期呼吸、循环的变化，测定麻醉阻滞平面，记录胎儿出生后的Apgar评分，观察记录产妇寒颤发生情况。结果两组产妇一般情况相同（P〉0．05）；两组产妇围术期呼吸变化差异无显著性（p〉0．05）；两组产妇在用药前后MAP均无明显变化（P〉0．05），Ⅰ组用药前后HR变化差异无显著性（p〉0．05），Ⅱ组用药后HR上升明显，差异有显著性（p〈0．05）；Ⅰ组有轻度寒颤4例，发生率为10％，Ⅱ组有轻度寒颤7例，重度寒颤5例，发生率为30％。结论长托宁用于预防围术期寒颤优于阿托品，且不良反应小，值得临床推广应用。

Objective Study the effect of Penehyclidine Hydroehloride injected before anesthesia to prevent the pcrioperative shivering of cesarean section. Methods 80 puerperants undergoing elective cesarean section in combined spinal - epidural anesthesia （ CSEA）, ASA Ⅰ-Ⅱ , were randomly divided into two groups, 40 in each group. GroupⅠ was given Penehyelidine Hydrochloride lmg before operation. Group Ⅱ was given atropine 0.5rag before operation. Continuous monitoring the change of respiratory -circulatory, determining the level of anesthesia, recording neonatal Apgar score, observing and recording oecurenee conditions of shivering. Results There was no remarkable difference in two group puerperants＇ general condition （p 〉 0.05） ; There was no remarkable difference in two group puerperants＇ change of respiratory（p 〉0.05） ; There were no remarkable difference in two group puerperants＇ change of MAP （p 〈0.05）. There were no remarkable difference in the change of HR in group Ⅰ ; And HR was increasing remarkably in group Ⅱ ; 4 puerperants had slightly shivering in Group Ⅰ , incidence is 10%. 7 puerperants had slightly shivering and 10 had severely shivering in group , incidence is 30%. Conclusion Penehyclidine Hydrochloride is better than atropine in preventing perioperative shivering, and have less adverse reaction. So deserves further clinical applications