布托啡诺与曲马多治疗椎管内麻醉术中寒颤的观察

Effects of Butorphanol and Tramadol on Shivering in Patients Undergoing Intraspinal Anesthesia

目的探讨布托啡诺与曲马多用于椎管内麻醉术中寒颤治疗的临床效果。方法选择手术过程中发生寒颤的60例患者，ASAI-Ⅱ级，随机分为3组，每组各20例，对照组使用生理盐水10mL，曲马多组在寒颤发生后静脉注射曲马多1mg／kg，布托啡诺组在寒颤发生后静脉注射布托啡诺0．01mg／kg。观察用药后恶心呕吐、心动过速、低血压和复发寒颤的例数。结果3组患者用药前寒颤评分没有差异，用药后曲马多组和布托啡诺组均可有效抑制寒颤反应，至用药后10min曲马多组和布托啡诺组患者均无寒颤反应。曲马多组患者恶心呕吐的发生率显著高于布托啡诺组（P〈0．05），并且在用药后30min有5例患者又出现寒颤。结论椎管内麻醉后的寒颤反应用布托啡诺O．01mg／kg或曲马多1mg／kg都可以有效抑制，但布托啡诺的副作用更少，并且寒颤复发的几率低，值得临床推广应用。

Objective To study the clinical effects of butmqohanol and tamadol on shivering in patients undergoing in- traspinal anesthesia. Methods 60 patients with shivering during surgeon were divided into 3 groups randomly. The control group was given saline 10 mL, the tramadol group were treated with intravenous injection of tramadol （ 1 mg/kg） after shivering; the hutorphanol group were treated with intravenous injection butorphanol （0. 01 mg/kg）. After treatment, nau- sea and vomiting, heartbeat taehycardia, hypotension and the number of shivering cases were observed. Results There was no significant difference in the three groups of shivering before treatment. After treatment, shivering of tramadol group and butorphanol group were effectively inhibited. There was no shivering after treatment 10mins later in those 2 groups. The rate of nausea and vomiting of tramadol group was higher than that of butorphanol group. After treatment, there were 5 ca- ses of shivering recurrence 30rains later. Conclusion Butorphanol （0. 01 mg/kg） and tramadol （ 1 mg/kg） can effective- ly inhibit shivering in patients undergoing intraspinal anesthesia, with fewer side effects and lower recurrence rate, whose clinical application is worthy to be recommended.