诺扬复合咪唑对剖宫产术后寒战反应的疗效观察

Observation of butorphanol coordinated with imidazole to shiver reaction after cesarean section

目的评价一定剂量布托啡诺复合咪达唑仑对产妇腰硬联合麻醉后寒战的疗效、镇静效果及不良反应的发生情况。方法选择腰硬联合麻醉下行剖宫产手术发生寒战的产妇150例,随机分为3组:A组咪达唑仑40μg/kg+布托啡诺10μg/kg,B组布托啡诺10μg/kg,C组曲马多1 mg/kg,发生寒战的产妇均在胎儿娩出后给予治疗药物,所用药物均用生理盐水稀释到5 ml。分别记录给药后3、5、10、30 min各时间点的HR、MAP、Sp O2和镇静评分;观察给药后产妇寒战停止时间和不良反应例数。结果各组治疗寒战有效率为98%(49例)、96%(48例)、100%(50例),差异无统计学意义;3组3、5、10、30 min各时间点的HR、MAP、Sp O2、镇静评分和治疗寒战有效率差异无统计学意义(P>0.05);A组寒战停止时间与B、C组比较差异有统计学意义(P<0.05);A、B组恶心呕吐例数与C组比较差异有统计学意义(P<0.05)。结论 3组药物均可治疗产妇腰硬联合麻醉期间的寒战,但布托啡诺联合咪达唑仑起效快、不良反应少,安全性高。

Objective To investigate the butorphanol compound midazolam combined spinal epidural anesthesia for the parturient after treating shivering,sedative effect and the incidence of adverse reactions. Methods The combined spinal epidural anesthesia for cesarean section operation chills maternal in 150 cases,they were randomly divided into 3 groups：group A,midazolam 40 μg / kg ＋ butorphanol 10 μg / kg;group B,butorphanol 10 μg / kg;and group C,tramadol 1 mg / kg,chills maternal at birth after the treatment of drugs,the drugs used were sodium chloride physiological solution was diluted to 5 ml. After administration of 3,5,10,30 min at each time point of HR,MAP,Sp O2,were recorded and the sedation score was observed;chill stop time after administration and number of adverse response in the 3 groups was recorded. Results There was no significant difference in 3,5,10,30 min HR,the MAP,Sp O2,and sedation score（P 〉0. 05） among the three groups. The effective rate of treatment group was 98%（49 cases）,chill for 96%（48 cases）,100%（50 cases） it was not statistically significant,A group and B,C shivering stops the time between the two groups was statistically significant（ P 〈0. 05）,when compared with the C group,nausea and vomiting of A,B group had statistical significance（ P 〈0. 05）. Conclusion Group A,midazolam 40 μg / kg ＋ butorphanol 10 μg / kg,group B butorphanol 10 μg / kg,group C tramadol 1 mg / kg can treat lumbar epidural anesthesia during the chills,but butorphanol combined with small dose of midazolam acted rapidly,with less adverse reaction and high security.