地佐辛预防硬膜外麻醉后患者寒战的临床观察

Clinical observation of dezocine in the prevention of shivering in the epidural anesthesia

目的探讨静脉注射地佐辛对硬膜外麻醉后寒战的预防效果。方法选择90例择期准备硬膜外麻醉后行下腹部、下肢手术的成年患者，随机分为地佐辛组、曲马多组和对照组，每组30例。于硬膜外麻醉注药前5min，地佐辛组静脉注射地佐辛5mg，曲马多组静脉注射曲马多100mg，对照组不用药。观察麻醉及手术过程中寒战发生率及严重程度。结果地佐辛组和曲马多组寒战发生率均为3．3％（1／30），明显低于对照组的30．0％（9／30）（P〈0．05）；地佐辛组用药前后患者的生命体征[平均动脉压（MAP），脉搏血氧饱和度（SpO2）、HR]变化差异无统计学意义（P〉0．05）。曲马多组在用药10min时MAP以及HR均较用药前有明显升高，差异有统计学意义[（92±11）mmHg（1mmHg=0．133kPa）比（87±14）mmHg，（89±13）次／min比（83±14）次／min，均P〈0．05]；SpO2在用药10、20min时均较用药前有明显降低[（94．5±1．2）％、（90．3±1．3）％比（99．4±0．9）％，均P〈0．05]。地佐辛组并发症发生率为20．0％（6／30），明显低于曲马多组的46．7％（14／30）（P〈0．05）。结论静脉注射地佐辛有助于预防低位硬膜外麻醉后寒战。

Objective To observe the effects of dezocine for the prevention of shivering in the epidural anesthesia. Methods Ninety cases of patients scheduled to undergo abdomen and lower limb operation were randomly divided into three groups： dzocine group （30 cases）, tramadol group （30 cases） and control group （30 cases）. Dzocine group was treated with 5 mg dzocine and the tramadol group were treated with tramadol 100 mg. The rate and severity of shivering during anesthesia and operation process were observed. Results The shivering rate of 3.3% （1/30） in dzocine group and tramadol group was significantly lower than that of control group [30.0% （9/ 30） ] （P 〈0.05）. The patient＇s vital signs [ mean arterial blood pressure （MAP）, pulse blood oxygen saturation （ SpO2 ） , heart rate（HR） ] changes in dezocine group before and after treatment had no significant difference （ P 〉 0.05）. MAP and HR in tramadol group in 10 rain medication were significantly increased [ （92 ± 11 ）mm Hg （1 mm Hg =0. 133 kPa） vs （87 ± 14）mm Hg, （89 ± 13） times/min vs （83 ± 14） times/min, P 〈 0.05] ; the level of SpO2 in 10, 20 rain medication significantly decreased [ （94.5 ± 1. 2） %, （ 90.3 ±1.3 ） % vs （99.4 ± 0. 9） %, P 〈 0.05 ]. The complication rate of 20.0% （6/30） in dzocine group was significantly lower than that of 46.7% （14/30） in tramadol group （ P 〈 0.05 ）. Conclusion Intravenous dezocine can prevent the incidence of shivering in the epidural anesthesia.