右美托咪定预防剖宫产腰硬联合麻醉寒战的临床观察

Clinical observation on dexmedetomidine in preventing chills after combined spinal-epidural anesthesia of cesarean section

目的探讨右美托咪定预防剖宫产孕妇腰硬联合麻醉期间寒战的临床疗效。方法选择在我院腰硬联合麻醉下行剖宫产术的孕妇90例,随机均分为3组,每组30例。胎儿娩出后分别静注右美托咪定0.5μg/kg(D组)、曲马多1mg/kg(T组)和生理盐水(N组)。按照设定的时间观察孕妇围术期呼吸和循环的变化,评估寒战级别和药物的不良反应。结果 D、T组孕妇麻醉后寒战发生率为10.0%和13.3%,均明显低于N组的40.0%(P<0.05);T组恶心呕吐发生率为33.3%,明显高于D组(6.6%)和N组(6.6%)(P<0.01)。结论右美托咪定可有效安全地预防剖宫产孕妇腰硬联合麻醉后的寒战反应,值得临床推广。

Objective To investigate the clinical efficacy of dexmedetomidine in the prevention of chills of gravidas undergoing cesarean section during combined spinal-epidural anesthesia. Methods 90 gravidas undergoing cesarean section under combined spinal-epidural anesthesia was randomly divided into 3 groups with 30 cases in each group. After parturition, 0.5 g/kg dexmedetomidine, 1 mg/kg tramadol and normal saline was intravenously infused to patients in Group D, Group T and Group N, respectively）. The changes of respiration and circulation during perioperative period of gravidas were observed according to prescheduled time, so as to evaluate the level of chills and adverse drug reactions. Results The incidence of post-anesthesia chill of gravidas in Group D and T was 10.0% and 13.3%, respectively, and significantly lower than that in Group N（40%）（P〈0.05）; the incidence of nausea and vomit in Group T was 33.3%, and significantly higher than that in Group D（6.6%） and N（6.6%）（P〈0.01）. Conclusion Dexmedetomidine can effectively and safely prevent chill reaction of gravidas undergoing cesarean section after combined spinal epidural anesthesia, and is worth clinical promotion.