地塞米松复合右美托咪定预防腰-硬联合麻醉剖宫产术中寒战的效果

Efficacy of dexamethasone combined with dexmedetomidine in preventing shivering during Cesarean section under combined spinal-epidural anesthesia

目的探讨地塞米松复合右美托咪定预防腰-硬联合麻醉剖宫产术中寒战的疗效。方法在腰-硬联合麻醉下行剖宫产产妇60例随机均分为四组,麻醉前分别静注生理盐水10ml(A组)、右美托咪定0.5μg/kg(B组)、地塞米松5mg(C组)和地塞米松复合右美托咪定(D组)。观察术中产妇寒战和呕吐的发生情况,记录新生儿Apgar评分。结果 D和C组产妇术中寒战发生率分别为20.00%和26.67%,明显低于B和A组的33.33%和53.33%(P<0.05)。D、C组产妇术中寒战者的寒战强度也明显弱于B、A组[(0.27±0.34)分、(0.42±0.57)分vs.(0.57±0.73)分、(0.96±1.08)分](P<0.05)。D、C组产妇呕吐的发生率和呕吐强度弱于也稍低于B、A组(P>0.05)。结论地塞米松复合右美托咪定可有效预防产妇腰-硬联合麻醉后的寒战。

Objective To observe the efficacy of dexamethasone combined with dexmedetomidine in prevention of shivering during Cesarean section under combined spinal-epidural anesthesia（CSEA）. Methods A total of 60 parturients undergoing Cesarean section under CSEA was equally randomized into 4 groups of A （normal saline）, B （dexmedetomidine 0. 5 μg/kg）, C （dexamethasone 5 mg） and D （dexmedetomidine 0.5μg/kg＋dexamethasone 5 mg）. The drug was injected before anesthesia. The incidence rates of shivering and vomiting during surgery were observed. Perioperative changes of BP and HR and Apgar scores of neonate were recorded. Results The incidence rats of shivering in groups of D and C were 20. 00% and 26. 67%, which were significantly lower than 33.33% and 53.33% in groups of B and A（P〈0. 05）. So did the shivering intensity of the parturients with shivering （P〈0. 05 ）. The incidence and intensity of vomiting were slightly lower in groups of D and C than those in groups of B and A（P〉0. 05）. Conclusion Dexamethasone combined with dexmedetomidine can effectively prevent shivering in parturients undergoing Cesarean section under CSEA.