右美托咪啶用于妇科腹腔镜手术全麻后寒战的效果:前瞻性、随机、单盲、临床对比研究

Effect of dexmedetomidine in preventing shivering after general anesthesia for laparoscopic surgery:a randomized,single-blinded,and placebo-controlled trial

目的探讨右美托咪啶在预防妇科腹腔镜手术全麻后寒战的有效性。方法将80例择期行妇科腹腔镜手术随机分为两组,每组40例。D组:在手术结束前30 min静脉缓慢注射右美托咪啶1.0μg/kg(注射时间超过10 min)。N组:右美托咪啶改为生理盐水。记录术前、术后10 min患者心率、平均动脉压、血氧饱和度数值,观察寒战的发生情况。同时观察、记录并处理有关不良反应。结果 N组的寒战发生率是37.5%,D组是7.5%,两组差异有统计学意义(P<0.05)。D组术后心率、平均动脉压与N组比较,差异有统计学意义(P<0.05)。D组镇静程度评分和口干发生率与N组比较,差异有统计学意义(P<0.05),而N组恶心和呕吐的发生率高于D组(P<0.05)。结论1.0μg/kg右美托咪啶用于妇科腹腔镜手术有一定的抗寒战作用,并且可以降低全麻后寒战的发生率。

Objective To evaluate efficacy of dexmedetomidine in preventing shivering after general anesthesia in women undergoing laparoscopic surgery.Methods Eighty patients scheduled for laparoscopic gynecological surgery were randomized into dexmedetomidine group（n=40） and control group（n=40） to receive 1.0 μg/kg dexmedetomidine or an equal volume of saline slowly injected（for over 10 min） at 30 min before the anticipated completion of surgery.The postoperative incidences of shivering and the side effects were recorded.Results The patients in the control group showed a significantly higher postoperative incidence of shivering（37.5%） than those in dexmedetomidine group（P0.05）.Heart rate and mean arterial pressure showed significant variations postoperatively in dexmedetomidine group（P0.05）,which had a significantly greater sedation score（P0.05）,a higher incidence of dry mouth（P=0.000）,but a significantly lower incidence of nausea and vomiting than the control group（P0.05）.Conclusion Dexmedetomidine can lower the incidence of shivering after general anesthesia for laparoscopic gynecological surgery.