预防性使用氯胺酮对减少剖宫产术中产妇寒战的效果观察

Prophylactic ketamine to prevent shivering in parturients undergoing cesarean delivery

目的比较氯胺酮0.25mg/kg和0.5mg/kg用于预防剖宫产病人术中寒战的有效性和安全性。方法 90名产妇随机分为3组,生理盐水组(C组,n=30);氯胺酮0.25mg/kg组(K^0.25,n=30);氯胺酮0.5mg/kg组(K^0.5,n=30)。每组病人在预充液体和实施完硬膜外麻醉后,静脉给予试验计划中的药品。记录病人的一般情况,发生寒战的等级及新生儿Apgar评分,术中麻黄碱和阿托品的使用情况。结果氯胺酮0.25mg/kg组和0.5mg/kg组产妇寒战的发生率显著低于生理盐水组(P<0.05),3组产妇新生儿Apgar评分无统计学意义(P>0.05)。结论在剖宫产病人身上使用0.25mg和0.5mg的氯胺酮都能有效的预防寒战的发生,且并无严重的并发症。

Objective To compare the efficacy and safety of ketamine 0.25 mg/kg with ketamine 0.5 mg/kg to prevent shivering in patients undergoing Cesarean delivery. Methods 90 patients were randomized to three groups ：saline（Group C,n=30）,intravenous（IV） ketamine 0.25 mg/kg（Group K-0.25,n=30）,or IV ketamine 0.5 mg/kg（Group K-0.5,n=30）. Patients characteristics, Apgar scores at 1 and 5 minutes,and side effects of the study drugs were recorded. Results The number of shivering patients was significantly less in Group K-0.25 and in Group K-0.5 than that in Group C（P〈0.05,P〈0.05,respectively）. Apgar scores in the three groups had no significant difference. Conclusions Prophylactic Ⅳ ketamine 0.25mg/kg was as effective as Ⅳ ketamine 0.5 mg/kg in preventing shivering in patients undergoing cesarean section during epidural anesthesia.