不同温度罗哌卡因剖宫产产妇寒战的临床观察

目的探讨寒战的发生与罗哌卡因温度的关系及其可能的原因。方法300例剖宫产产妇随机分为三组（Ⅰ组、Ⅱ组和Ⅲ组），每组100例。对照组（Ⅰ组）硬膜外腔分次给予37％0．75％罗哌卡因15ml；实验组（Ⅱ组）硬膜外腔分次给予25℃0．75％罗哌卡因15m1；实验组（Ⅲ组）硬膜外腔分次给予15℃0．75％罗哌卡因15ml。观察记录产妇术中寒战发生的情况（寒战评级、寒战出现时间、寒战停止时间），并持续监测术期呼吸循环的变化，记录胎儿出生后的Apgar评分。结果Ⅰ组、Ⅱ组、Ⅲ组剖宫产产妇寒战的发生率分别为18％、34％、77％。与Ⅰ组比较，Ⅱ组、Ⅲ组寒战出现时间早、停止时间长、寒战评级更高；与Ⅱ组比较，Ⅲ组寒战出现时间早、停止时间长、寒战评级更高。结论罗哌卡因温度下降，寒战程度加重，发生率增加。

Objective To study the relationship between shivering and the temperatures of ropivacaine and the possible causes. Methods Three hundred maternity patients were randomly divided into 3 groups （100each） ：group Ⅰ, group Ⅱ, group Ⅲ administered respectively fractionated doses 37 ℃ 0. 75% ropivaeaine 15 ml,25℃0. 75% ropivacaine 15 ml,15℃ 0. 75% ropivacaine 15 ml. To observe the rating,occurrence time, offtime of shivering;to monitor the changes of breathing and circulation;to record Apgar score of the fetus. Resuits The incidence rate of shivering in group Ⅰ,group Ⅱ,group Ⅲ respectively18% ,34% ,77%. Comparing with group Ⅰ, the shiver appears more early and stops more lately and grades more seriously in group Ⅱ and group Ⅲ;Comparing with group Ⅱ, the shiver appears more early and stops more lately and grades more seriously in group Ⅲ. Conclusion The degree of shivering makes more serious and the incidence rate increased with the temperature of ropivacaine droped.