不同剂量氢化可的松预防膝关节镜术中寒颤的临床应用比较

Comparative study on effect of different doses of hydrocortisone for reducing intraoperative shivering inpatients undergoing knee arthroscopy

目的评价不同剂量的氢化可的松(糖皮质激素类)预防膝关节镜手术患者术中寒颤的疗效和安全性。方法 90例膝关节镜手术行腰硬联合麻醉的患者,随机分为3组:A组氢化可的松1 mg.kg-1+芬太尼50μg,B组氢化可的松2 mg.kg-1+芬太尼50μg,C组生理盐水5 mL+芬太尼50μg。结果 A组与B组的寒颤发生率分别为33%与20%,均明显低于C组的66%,差异有统计学意义(P<0.01);A组与B组差异无显著性(P>0.05)。结论氢化可的松用于膝关节镜手术中能有效预防术中的寒颤,2种剂量间无显著性差异。

Objective To investigate the effect and safety of different doses of hydrocortisone for reducing intraoperative shivering undergoing knee arthroscopy.Methods Combined spinal epidural anesthesia was administered on ninety patients undergoing knee arthroscopy.They were randomized to receive hydrocortisone 1 mg·kg-1 with fentanyl 50 μg iv（group A;n =20）;hydrocortisone 2 mg·kg-1 with fentanyl 50 μg iv（group B;n=20） or normal saline 5 mL with fentanyl 50μg iv（group C;n=20）.Results Shivering was observed in 10 patients（33%） in group A and 6 patients（20%） in group B,which were significantly lower than 20 patients（66%） in group C（P0.05）.The overall incidence of shivering in group A was similar with that of group B（P=0.38）.Conclusion Hydrocortisone（1-2 mg·kg-1 iv） with fentanyl 50 μg provides effective prophylaxis against intraoperative shivering in patients undergoing knee arthroscopy.