硫酸镁对前列腺电切手术者术中寒战的影响

Effects of magnesium sulphate on operative shivering in transurethral resection prostate

目的观察硫酸镁对经尿道前列腺电切术术中血流动力学、术中寒战的影响。方法经尿道前列腺电切术术中出现寒战反应的患者80例,年龄60~87岁,体重45~88kg、ASAI~Ⅲ级,随机被分为硫酸镁组和对照组各40例。采用蛛网膜下腔阻滞麻醉,当患者出现寒战2min仍不消失,硫酸镁组给予硫酸镁10mg/kg,对照组以盐酸曲马多1 mg/kg。观察寒战消失情况、患者围手术期平均动脉压（MAP）和心率（HR）。结果两组寒战消失和寒战减轻比率差异无统计学意义（P〉0.05）,用药前及用药后1 min、5 min及30 min SBP、SDP及HR两组间及组内比较均无明显变化,差异无统计学意义（P〉0.05）。给药后硫酸镁组恶心呕吐、呼吸抑制、嗜睡的发生率明显较对照组低,差异有统计学意义（P〈0.05）。结论硫酸镁能安全有效的治疗蛛网膜下腔阻滞下行前列腺电切术术中出现的寒战反应。

Objective To investigate the effect of magnesium sulphate on hemodynamics and operative shivering in transurethral resection prostate.Methods Eighty patients（ASAⅠ~Ⅲ） aged 60~87 years old undergoing transurethral resection prostate with operative shivering were randomized equally into two groups,magnesium sulphate group and the control group,each with 40 cases.All the patients underwent subarachnoid block.When the patients showed operative shivering for more than 2 min,the magnesium sulphate group were administrated with 10 mg/kg magnesium sulphate,while the control group were administrated with 1 mg/kg tramadol.Operative shivering,blood pressure,heart rate（HR） and SpO2 were recorded.Results Rate of disappearance of shivering and remission rate of shivering showed no statistically significant difference between the two groups（P0.05）.SBP,DBP,HR at 1 min,5 min and 30 min after administration showed no statistically significant difference with that before administration,and SBP,DBP,HR at 1 min,5 min and 30 min after administration as well as that before administration also showed no statistically significant difference between the two groups（P0.05）.The incidences of respiratory inhibition,nausea and hypersomnia were lower in Magnesium sulphate group,compared with control group（P0.05）.Conclusion Magnesium sulphate can be safely and effectively used for treating operative shivering in patients undergoing ransurethral resection prostate with subarachnoid block.