右美托咪定对硬膜外麻醉后寒战和呼吸循环的影响？

Effect of Dexmedetomidine on Shivering,Respiration and Circulation after Epidural Anesthesia

目的探讨右美托咪定对硬膜外麻醉后寒战和呼吸循环的影响。方法选取2013年1月至6月于本院进行择期手术 ASA Ⅰ~Ⅱ级患者60例,将其随机分为序贯法组和点斜法组各30例。序贯法组按照序贯法测定 ED50的要求进行测定；点斜法组按照点斜法测定 ED50的要求进行测定。观察记录给药前及给药第15、30、60 min平均动脉压（MBP）、心率（HR）、呼吸频率（RR）、脉搏血氧饱和度（SpO2）及寒战发生率。结果组内比较,两组患者给药前及给药15、30、60 min时 HR、MBP比较差异无统计学意义（P ＞0.05）；组间比较,两组患者各时间点 HR、MBP比较差异无统计学意义（P ＞0.05）。组内比较,两组患者给药前及给药15、30、60 min SpO2、RR比较差异无统计学意义（P ＞0.05）；组间比较,两组患者各时间点 SpO2、RR的差异无统计学意义（P ＞0.05）。两组患者在麻醉后寒战分级及发生率比较差异无统计学意义（P ＞0.05）。结论两种方法测定右美托咪定麻醉后寒战 ED50均为0.4μg/kg,两种方法均可以用于麻醉后寒战 ED50的测定。

Obj ective]To explore the effect of dexmedetomidine on shivering,respiration and circulation after epidural anesthesia.[Methods]A total of 60 ASAⅠ~Ⅱ patients undergoing elective surgery in our hos-pital from Jan.2013 to June 2013 were chosen and randomly divided into sequential method group and point-slope method group with 30 patients in each group.ED50 of sequential method group was determined in accord-ance with the requirements of sequential method,while ED50 of point-slope method group was determined in accordance with the requirements of point-slope method.Mean arterial pressure（MBP）,heart rate（HR）,re-spiratory rate（RR）,oxygen saturation（SpO2 ）and the incidence of shivering before,15,30 and 60min after medication were observed and recorded.[Results]There was no significant difference in HR and MBP of two groups among before,15,30 and 60min after medication（P 〉0.05）.There was no significant difference in HR and MBP at each time point between two groups（P 〉0.05）.There was no significant difference in pPO2 and RR of two groups among before,15,30 and 60min after medication（P 〉0.05）.There was no significant difference in SpO2 and RR at each time point between two groups（P 〉0.05）.There was no significant differ-ence in the classification and incidence of shivering between two groups（P 〉0.05）.[Conclusion]ED50 of shivering after dexmedetomidine anesthesia determined by both two methods are 0.4μg/kg.The two methods can be used to determine ED50 of shivering after anesthesia.