椎管内麻醉后寒战反应的临床相关因素分析

Clinical relevant factors of postoperative shivering in intravertebral anesthesia patients

目的探讨椎管内麻醉后寒战反应的临床相关影响因素。方法 1 500例椎管内麻醉下行手术且术后回麻醉恢复室者,按有无寒战反应发生分为寒战组(n=734)和无寒战组(n=766),记录患者一般情况、鼓膜温度、麻醉方式、麻醉阻滞平面、术中出血量及手术时间。结果两组间年龄、性别、中心体温、麻醉方式、麻醉平面、手术时间和术中出血量差异有统计学意义﹙P<0.05﹚,且与寒战发生相关。结论年轻患者、男性患者、体温下降、行蛛网膜下腔阻滞、麻醉平面过高﹙大于等于胸8≥T8﹚、手术时间长、术中出血量过多为椎管内麻醉患者术中或术后发生寒战反应的危险因素。

[ Objective ] To explore the clinical relevant factors of postoperative shivering in intravertebral anaesthesia patients. [Methods ] A total of 1 500 patients, aged from 15-76 years old, undergoing intravertebral anaesthesia in postanesthesia care unit （PACU） after surgeries were devided into shivering group （n = 734） and non-shivering group （n = 766）. Tympanic temperature was monitored. General data of patients, anesthetic ways, anesthetic block levels, operative time and intraoperative hemorrhage were recorded. [ Results ] There were significant differences in age, sex, core temperature, anesthetic ways, anesthetic block levels, operative time and blood loss between two groups （P 〈 0.05）. These factors were positively correlated with intraoperative or postoperative shivering. [ Conclusions] The risk factors for intraoperatlve or postoperative shivering in intravertebral anesthesia patients includes younger patients, male, lower temperature, undergoing spinal anesthesia, higher anesthetic block level （≥ Ts）, longer operative time and intraoperative massive hemorrhage.