氯丙嗪对神经外科术中控制性浅低温控温效果的影响

Chlorpromazine Increase Cooling and Rewarming Rate during Intraoperative Deliberate Mild Hypothermia in Neurosurgical Procedures

【目的】研究氯丙嗪对神经外科术中控制性浅低温的降温和复温速率的影响。【方法】择期脑肿瘤切除术患者40例,ASAⅡ或Ⅲ级,年龄18～65岁,随机分为2组(n=20),对照组和氯丙嗪组。均采用气管内静吸复合全身麻醉。氯丙嗪组在麻醉诱导后静脉注射氯丙嗪25mg。两组患者在麻醉诱导后均通过充气控温毯进行控制性降温,设定目标温度为34℃,肿瘤切除前30min开始复温。每5min纪录一次中心温度(鼻咽温),观察术中和术后的不良反应及并发症。【结果】在肿瘤切除前,对照组和氯丙嗪组分别有60%和90%的患者中心体温达到34℃,其差异有统计学意义(P<0.05)。对照组和氯丙嗪组的降温速率分别为(1.05±0.06)℃/h和(1.29±0.08)℃/h(P<0.05),差异有统计学意义。对照组和氯丙嗪组的复温速率分别为(0.75±0.05)℃/h和(0.91±0.07)℃/h(P<0.05),差异有统计学意义。【结论】氯丙嗪增加神经外科术中控制性浅低温降温和复温的速率。

[Objective] To evaluate the effects of chlorpromazine on cooling and rewarming rate during intraoperative deliberated mild hypothermia in neurosurgical procedures. [Methods] Forty patients undergoing neurosurgical procedures were randomly assigned to control group or chlorpromazine group, with 20 patients in each group. After anesthesia induction, 25 mg chlorpromazine was administrated intravenously in chlorpromazine group. All patients were cooled by air-forced blanket and the target temperature was set to 34 ℃ during the processes of tumor removing. The nasopharynx temperature was measured as core temperature every 5 min during operation. [ Results ] The rate of attaining to target temperature （34 ℃ ） in chlorpromazine group before tumor removing was significant higher than that in control group （90% vs 60%, P 〈 0.05）. The cooling rate was significant higher in chlorpromazine group than that in control group （1.29 ＋ 0.08 vs 1.05± 0.06, P 〈 0.05）. The rewarming rate was significant higher in chlorpromazine group than that in control group （0.91± 0.07 vs 0.75± 0.05, P 〈 0.05）. [Conclusion] Chlorpromazine increases cooling and rewarming rate during intraoperative deliberated mild hypothermia in neurosurgical procedures.