不同剂量右美托咪啶防治剖宫产术中寒战的临床观察

Clinical observation about different doses of dexmedetomidine in prevention of shivering during cesarean section

目的探讨不同剂量右美托咪啶防治腰硬联合麻醉剖宫产术中寒战的效果。方法 60例腰硬联合麻醉下行剖宫产术产妇,随机分为3组:右美托咪啶1组(D1组),右美托咪啶2组(D2组),对照组(C组)。胎儿取出即刻,D1、D2组分别于10min内泵注0.5μg/kg、1.0μg/kg右美托咪啶;对照组泵入10ml生理盐水。观察注药时(T_0)、注药后5min(T_1)、腹腔探查时(T_2)、手术结束时(T_3)的平均动脉压(MBP)、血氧饱和度(SpO_2)、心率(HR)、术中寒战发生例数以及术后不良反应。结果与C组比较,D1、D2组寒战发生率明显降低(P<0.05),D1组用药后不良反应比D2组发生率低(P<0.05)。结论 0.5μg/kg右美托咪啶静脉注射能够有效防治剖宫产术中寒战的发生,且不良反应少。

Objective To investigate the effect on the prevention of shivering in spinal-epidural anesthesia by different dose of dexmedetomidine during cesarean section. Methods 60 cases of spinal-epidural anesthesia accepted cesarean section parturients were randomly divided into three groups： dexmedetomidine group 1 （group D1 ）, dexmedetomidine group 2 （group D2）, control group （group C）. As soon as fetus was removed, 0.5μg/kg and 1.0μg/kg dexmedetomidine were infused in group D1 and D2 in 10 minutes respectively. Group C was pumped into 10ml physiological saline. Mean arterial pressure （MBP）, blood oxygen saturation（SpO2）, heart rate （HR）, the incidence of shivering during operation, postoperative adverse reaction were ob- served at drug injection time （T0）, 5 minutes after injection （T1）, abdominal exploration time （T2） and the end of operation （T3）. Results Compared with group C, group D1 and D2 significantly reduced the incidence of shivering （P〈0.05）, the drug adverse reaction incidence of group DI was lower than that in group D2 （P〈0.05）. Conclusion 0.5μg/kg dexmedetomidine intravenous injection can effectively prevent and control the shivering during cesarean section, and has less adverse reaction.