不同剂量右美托咪定滴鼻预防肝叶切除术后寒战的疗效

Clinical Observation of Different Doses of Intranasal Dexmedetomidine to Prevent Postoperative Shivering after Hepatectomy

【目的】观察不同剂量右美托咪定(Dex)滴鼻预防肝叶切除术后术后寒战的效果。【方法】腹腔镜下肝叶切除术患者120例;随机分为四组;每组30例;对照组(C组)气管导管拔出前予以生理盐水;D1、D2、D3组分别予以Dex 0.5 μg/kg、1 μg/kg、2 μg/kg双侧鼻腔滴入。比较各组患者鼻咽温、寒战分级、苏醒时间、拔管时间以及不良反应发生率。【结果】D1组与C组比较术后寒战发生率和严重程度差异无显著性(P>0.05);D2组、D3组明显低于C组(P<0.05);D2组、D3组之间比较差异无显著性(P>0.05)。C组、D1组、D2组苏醒时间、拔管时间和镇静发生率比较差异无显著性(P>0.05);D3组患者苏醒时间、拔管时间和镇静发生率高于C组(P<0.05)。四组恶心呕吐、呼吸抑制发生率比较差异无显著性(P>0.05)。【结论】预防性经鼻给予1 μg/kg Dex可以有效预防肝叶切除术患者苏醒期寒战的发生。

【Objective】 To investigate the effects of different doses of dexmedetomidine(Dex) nasal drops in the prevention of postoperative chills after hepatectomy.【Methods】 A total of 120 patients with laparoscopic lobectomy were randomly divided into four groups with 30 patients in each group. Patients in the control group (group C) received normal saline before tracheal catheter extraction, while patients in group D1, D2 and D3 received Dex 0.5μg/kg、1μg/kg、2μg/kg, respectively.The incidence of nasopharyngeal temperature, grade of shivering, waking time, extubation time and other adverse reactions were recorded. 【Results】 There was no significant difference in the incidence and severity of postoperative shivering between group D1 and group C (P> 0.05). Compared to group C, the incidence and severity of postoperative shivering were significantly lower in group D2 and group D3 (P <0.05). However, there was no significant difference between group D2 and D3 (P>0.05). There was no significant difference in waking time, extubation time and sedation incidence among group C, D1 and D2 (P>0.05). The recovery time, extubation time and sedation rate of patients in group D3 were higher than those in group C (P<0.05). There was no significant difference in the incidence of nausea, vomiting and respiratory depression in all four groups (P>0.05). 【Conclusion】 Prophylactic intranasal administration of 1μg/kg of Dex in patients with hepatic lobectomy can effectively prevent postoperative shivering.