右美托咪定对下肢手术腰麻后寒颤的影响

Dexmedetomidine prevents shivering in patients undergoing lower extremity operation during spinal anesthesia

目的观察右美托咪定对下肢手术腰麻后寒颤的预防作用。方法择期下肢手术患者60例,随机均分为两组,麻醉前分别静脉滴注右美托咪定1μg/kg(D组)或生理盐水100ml(C组)。选择L2～3或L3～4间隙腰麻,0.5%罗哌卡因10mg,控制麻醉平面在T10以下。记录用药前、用药后15、30min的MAP、HR和SpO2,及术中寒颤的发生情况。结果与用药前及C组比较,用药后15、30min,D组MAP明显降低,HR明显减慢(P<0.05),SpO2组间差异无统计学意义。D组术中有4例(13.3%)患者发生寒颤,明显低于C组的12例(40.0%)(P<0.05)。结论右美托咪定1μg/kg可有效防治下肢手术腰麻后寒颤的发生,但可能引起血流动力学波动。

Objective To observe the effect of dexmedetomidine on preventing shivering in patients during spinal anesthesia. Methods Sixty ASA I or H patients undergoing selective lower extremity operation under spinal anesthesia were randomly divided into two groups（n： 30 each）. Patients were intravenously injected dexmedetomidine 1 μg/kg （dissolved in 100 ml saline, group D） or same volume of saline （group C） before spinal anesthesia. The changes of vital signs after injection 15,30 rain were recorded. The occurrence of shivering was observed. The incidence of adverse reaction was recorded. Results Mean arterial pressure （MAP）and heart rate （HR） were lower in group D than in group C at 15 and 30 rain after injection（P〈0. 05）. There was no significant difference in saturation of oxygen（SpO2 ） between the two groups. Group D （13. 3%） had a lower shivering incidence than the group C （40. 0%） （P〈0. 05）. There was no significant difference in the incidence of adverse reaction between the two groups. Conclusion Dexmedetomidine may be effective in preventing shivering during spinal anesthesia.