倍他米松预防腰麻剖宫产术中寒颤临床观察

Study on the Effect of Betamethasone for Cesarean Section Under Spinal Anesthesia on Postanesthetic Shivering

目的探讨倍他米松在预防腰麻剖宫产术中寒颤的临床作用。方法 90例择期腰麻剖宫产产妇,随机分为实验组及对照组各45例。在麻醉平面稳定后实验组及对照组分别静脉注射倍他米松4 mg和等体积生理盐水。观察并评价两组产妇术中寒战发生情况、产妇术中生命体征及胎儿出生后Apgar评分。结果对照组中产妇术中寒颤发生共21例,发生率为46.7%,3级以上寒战共发生6例,占寒战总人数28.5%;实验组术中寒颤发生共7例,发生率为15.5%,3级以上寒战共发生2例,占寒战总人数13.3%。实验组寒战的发生率及分级显著降低,两组间寒战发生率及程度比较差异有统计学意义(P<0.05);两组产妇围术期呼吸循环监测及胎儿出生后Apgar评分比较差异无统计学意义(P>0.05)。结论普通剂量倍他米松可以有效预防腰麻下剖宫产产妇术中寒颤。

Objective To study the effects of betamethasone on preventing shiver during surgery in cesarean section parturients under spinal anesthesia. Methods 90 pregnant women for elective caesarean section under spinal anesthesia were selected and divided randomly into an experimental group and a control group, 45 cases in each group. Parturients in experimental group and in control group were respectively injected 4 mg of betamethasone and normal saline after anesthetic level fixed. The incidence of shivering and its severity as well as the changes of vital signs were observed, recorded Apgar score of neonates. Results Control shiver in the middle women group occurred in 21 cases, the incidence rate was 46.7%, grade 3 or more chills there were 6 cases, accounted for 28.5% of the total number of chills, shiver in the experimental group occurred in a total of 7 cases, the incidence rate was 15.5%, grade 3 or more chills there were 2 cases, accounted for 13.3% of the total number of chills. Shivering in the experimental group the incidence and grade decreased significantly, between the two groups shivering rate and degree of the difference was statistically significant（P〈0.05）, the women in the two groups perioperative respiratory and circulatory monitoring fetal and postnatal Apgar score differences were no statistical significance（P〈0.05）. Conclusion Ordinary dose of betamethasone can effectively prevent spinal anesthesia shivering in parturients undergoing cesarean section.