右美托咪啶对宫外孕腹腔镜术后寒战的影响

Effect of dexmedetomidine on shivering after laparoscopic surgery of ectopic pregnancy

目的：评价右美托咪啶（dexmedetomidine,DEX）对腹腔镜宫外孕术后寒战的影响。方法：全麻下行腹腔镜宫外孕手术患者120例,ASA分级Ⅰ或Ⅱ级,将患者随机分为4组（n=30）：生理盐水对照组、右美托咪啶组、输血对照组（输血组）和输血右美托咪啶组（输血DEX组）。4组的麻醉诱导及维持方法相同,术中维持BIS值40~55。右美托咪啶组开放静脉后静脉输注右美托咪啶0.5μg·（kg·h）-1至手术结束前0.5 h;生理盐水组静脉输注等容量生理盐水;输血DEX组（术中出血大于800 mL酌情输注血液）开放静脉后静脉输注右美托咪啶0.5μg·（kg·h）-1至手术结束前0.5 h;输血组（术中出血大于800 mL酌情输注血液）静脉输注等容量生理盐水;记录术后1 h内寒战发生情况。结果：生理盐水组、右美托咪啶组、输血组、输血DEX组寒战发生率分别为50%（15例）、10%（3例）、57%（17例）和20%（6例）。与生理盐水组比较,右美托咪啶组寒战发生率降低,寒战程度减轻（P〈0.05）;与输血组比较,输血DEX组寒战发生率降低,寒战程度减轻（P〈0.05）。结论：右美托咪啶辅助麻醉可降低宫外孕患者麻醉后寒战的发生概率。

Objective： To evaluate the effects of dexmedetomidine on shivering after laparoscopic surgery of ectopic pregnancy.Methods： A total of 120 cases ASA I or II patients in the operation under general anesthesia in laparoscopy for ectopic pregnancy were randomly divided into 4 groups（n = 30 each） ： normal saline control group（group N）,dexmedetomidine group（group D） and blood transfusion control group（group Bb）,blood transfusion dexmedetomidine group（group Bd）.Four groups using the same anesthesia induction and maintenance methods.BIS was maintained at 40-55 during surgery.Group D received dexmedetomidine intravenous infusion at 0.5 μg·（kg·h）-1from immediately after open the vine until 0.5 h before the end of operation,group N received the equal volume of normal saline.Group Bd（when the amount of blood loss greater than 800 mL infusion of blood） received dexmedetomidine intravenous infusion at 0.5 μg·（kg ·h）-1from immediately after opening the vein until 0.5 h before the end of operation and group Bb（when the amount of blood loss greater than 800 mL infusion of blood） received the equal volume of normal saline.The shivering within 1 h after operation was scored and recorded.Results： The incidence rate of postanesthetic shivering was 50% in group N,57% in group Bb,20% in group Bd and 10% in group D.Compared with group N,the incidence rate and degree of shivering were decreased in group D（P 0.05）.Compared with group Bb,the incidence rate and degree of shivering were decreased in group Bd（P 0.05）.Conclusion： Dexmedetomidine-assisted anesthesia can reduce the incidence of postanesthetic shivering in patients with ectopic pregnancy.