术前应用倍他米松对腰麻下剖宫产产妇术中寒战的影响

Effects of betamethasone administrated before surgery on shiver during surgery in cesarean section parturients under spinal anesthesia

目的探讨手术前预先静注不同剂量倍他米松对腰麻下剖宫产产妇术中寒战的影响。方法选择ASAⅠ级、胎心率正常、无肾上腺皮质激素禁忌证、麻醉前无寒战的产妇120例,随机分为C组(对照组)、B2组(倍他米松2 mg组)、B4组(倍他米松4 mg组)和B8组(倍他米松8 mg组),每组30例。各组患者在腰麻平面稳定后静脉注射倍他米松或生理盐水。持续观察各组产妇呼吸和循环变化,记录胎儿出生后Apgar评分,观察产妇术中寒战情况。结果 4组产妇一般情况比较差异无统计学意义(P>0.05);4组产妇呼吸通畅,脉搏血氧饱和度(SpO2)均在97%以上,围术期呼吸循环变化比较差异无统计学意义(P>0.05);4组胎儿出生后Apgar评分比较差异无统计学意义(P>0.05);各倍他米松组产妇麻醉后寒战的发生率显著降低,且寒战程度较轻(P<0.05),B4组和B8组较B2组寒战发生率显著降低,且寒战程度较轻(P<0.05),B4组和B8组之间寒战发生率及程度比较差异无统计学意义(P>0.05)。结论术前应用倍他米松4 mg以上可以安全有效预防腰麻下剖宫产产妇术中寒战。

Objective To research proper dosage of betamethasone administrated before surgery that can relieve shiver during surgery in cesarean section parturients.Methods 120 cases,ASAⅠ parturients undergoing cesarean section were randomly allocated to 4 groups（30 cases in each group）,2 mg of dexamethasone,4 mg of dexamethasone,8 mg of dexamethasone and normal saline were intravenously injected respectively after anesthetic level fixed.Observed the change of parturients′ resperation and blood pressure continuously and shiver of parturients,recorded Apgar score of neonatus.Results There were no signicant differences in SpO2,BP and Apgar score among 4 groups.The rating and score of shiver of parturients in B2 group,B4 group and B8 group were significantly lower than those of C group.The rating and score of shiver of parturients in B4 group and B8 group were significant lower than those of B2 group.The rating and score of shiver of parturients had no significant difference between B4 group and B8 group.Conclusion Betamethesone no less than 4 mg administrated before surgery can effectively and safely prevent shiver of parturients undergoing cesarean section in surgery.