保温与能量合剂干预对剖宫产腰硬联合麻醉后寒战的影响

The effect of combined intervention with thermal retardation and energy mixture on the post cesarean section shivering under combined spinal and epidural anesthesia

目的观察术中保温与能量合剂共同干预对剖宫产腰硬联合麻醉后寒战的预防作用。方法将本院腰硬联合麻醉下行剖宫产术的产妇210例,随机分为对照组(Ⅰ组)、保温组(Ⅱ组)、保温+能量合剂组(Ⅲ组)。测量并记录入手术室时(T0)、切皮前(T1)、胎儿取出后5min(T2)、离开手术室时(T3)和返回病房后5min(T4)腋下体温。记录术中及术后2h产妇寒战的发生情况。并对所测结果进行比较分析。结果与T0时间点比较,Ⅰ组T2、T3、T4时间点的体温明显下降(P<0.05),而Ⅱ组和Ⅲ组无明显降低(P>0.05)。与Ⅰ组的时间点比较,Ⅱ组和Ⅲ组T0、T1时间点体温无明显变化(P>0.05),Ⅱ组和Ⅲ组T2、T3、T4时间点的体温明显升高(P<0.05)。结论保温与能量合剂干预可降低剖宫产腰硬联合麻醉后寒战的发生。

Objective To evaluate the preventive effect of combined intervention with thermal retardation and energy mixture on the post cesarean section shivering under combined spinal and epidural anesthesia（CSEA）.Methods Two hundred and ten pregnant females undergoing cesarean delivery under CSEA of the hospital were randomized to group Ⅰ（control）,group Ⅱ（thermal retardation）and group Ⅲ（thermal retardation and energy mixture）.The armpit temperatures at the time points of entering the operation room（T0）,prior to the skin cutting（T1）,5min after infant delivery（T2）,leaving the operation room（T3）and 5min after back to the inward（T4）were recorded.The shivering incidence and severity during the surgery and within 2hafter the surgery was observed.The data of the 3groups were analyzed and compared.Results Compared with T0,the temperature at T2,T3 and T4was significant lower in groupⅠ（P〈0.05）;while in groupⅡ orⅢ,those temperatures had no significant difference with T0（P〉0.05）.Compared with the corresponding time point in groupⅠ,the temperature at T0 and T1had no significant difference（P〉0.05）,while temperatures at T2,T3 and T4were obviously higher（P〈0.05）.Conclusion The combined intervention with thermal retardation and energy mixture could reduce the shivering after cesarean delivery under CSEA.