不同剂量曲马朵治疗全身麻醉术后寒战疗效比较

Comparison of the effects of different doses of tramadol in the treatment of patients with postoperative shivering after general anesthesia

目的比较不同剂量曲马朵治疗全身麻醉术后寒战的临床疗效以及不良反应发生情况，探讨曲马朵治疗全身麻醉术后寒战的适宜剂量。方法选取进行全身麻醉腹部手术的患者87例，并按患者意愿分为五组。对照组17例不给予曲马朵治疗；观察1组17例静脉注射曲马朵0．5mg／kg进行治疗；观察2组17例静脉注射曲马朵1．0mg／kg进行治疗；观察3组18例静脉注射曲马朵1．5mg／kg进行治疗；观察4组18例静脉注射曲马朵2．0mg／kg进行治疗。治疗后，对发生寒战患者的寒战程度进行评分，观察五组患者治疗前后寒战评分的差异，比较不同剂量曲马朵治疗全身麻醉术后寒战的临床疗效以及不良反应发生情况。结果使用曲马朵治疗可明显降低患者的寒战评分，提高疗效，各组不良反应发生率分别为0．00％、0．00％、0．00％、5．56％、61．11％，总有效率分别为11．76％、70．59％、100．00％、94．44％、77．78％。观察2组的临床疗效明显优于其他组，差异有统计学意义（x^2=9．85，P〈0．05）。结论曲马朵使用剂量为1．0mg／kg或1．5mg／kg，既能显著提高全身麻醉术后寒战的临床疗效，又能减少不良反应的发生，是临床上治疗该病的最佳剂量，值得在临床上推广使用。

Objective To compare the clinical efficacy and adverse reactions of different doses of tramadol in the treatment of patients with postoperative shivering after general anesthesia and to explore the appropriate dose of tramadol for the treatment of general anesthesia shivering. Methods 87 cases who required elective general anesthe- sia in patients with abdominal surgery were selected in our hospital. They were divided into five groups according to the wishes of patients. Among them, 17 patients of the control group did not receive tramadol. 17 patients of the obser- vation group one were given intravenous tramadol 0.5mg/kg. 17 patients of the observation group two were given intra- venous tramadol 1.0mg/kg. 18 patients of the observation group three were given intravenous tramadol 1.5mg/kg and 18 patients of the observation group four were given intravenous tramadol 2.0mg/kg. After treatment, the degree of chills of the patients was evaluated. The difference of the chills score of five groups was observed before and after treatment. The clinical efficacy and adverse reactions of different doses of tramadol were compared. Results Tramadol could significantly reduce the shivering score and improve the efficacy. The incidence rate of adverse reactions was 0. 00% ,0.00% ,0.00% ,5.56% ,61.11% ,and the total effective rate was 11.76% ,70.59% , 100.00% ,94.44% , 77.78% in five groups. The clinical efficacy of the observation group two were significantly better than ＇the other groups,the difference was statistically significant （ x^22 = 9.85, P 〈 0. 05 ）. Conclusion Tramadol at the dose of 1.0mg/kg or 1.5mg/kg can not only significantly improve the clinical efficacy of postoperative shivering, but also can reduce the incidence rate of adverse reactions. It is the optimal dose for clinical treatment, which is worthy of clinical application.