右美托咪定防治前列腺电切术患者寒颤的临床观察

Clinical observation of preventive effect of dexmedetomidine on shivering in patients undergoing transurethral prostatectomy

目的:观察右美托咪定防治经尿道前列腺电切术患者寒颤的临床效果。方法:选择择期在腰硬联合麻醉下经尿道前列腺电切术(TURP)的患者69例,随机分为右美托咪定组(D组)、曲马多组(T组)、对照组(C组),每组23人。D组静脉泵注右美托咪定负荷量0.5μg·kg^(-1),随后以0.2~0.3μg·kg^(-1)·h-1维持泵注至手术结束前0.5 h;T组静脉注射曲马多负荷量0.6 mg·kg^(-1),随后以1 mg·kg^(-1)泵注至手术结束前0.5 h;C组给予等量的生理盐水泵注。记录麻醉前(T1)、手术开始后45 min(T2)、术毕(T3)患者的体温和镇静状态评分;记录寒颤评级和恶心呕吐等情况。结果:三组组间对应时点的体温无差异(P>0.05),T2和T3的体温均低于T1(P<0.05);D组和T组的镇静评分高于C组(P<0.05);D组和T组的寒颤发生率低于C组(P<0.05);T组恶心呕吐的发生率高于D组和C组(P<0.05)。结论:右美托咪定可以防治经尿道前列腺电切术患者的寒颤,比曲马多更有优越性。

Objective：To observe the effect of dexmedetomidine on preventing shivering in patients undergoing transurethral prostatectomy.Methods：A total of sixty-nine patients scheduled for transurethral prostatectomy under combined spinal epidural anesthesia were randomly divided into three groups.In patients of dexmedetomidine group（group D）,dexmedetomidine 0.5 ktg.kg^-l were infused intravenously, followed by infusion at the rate of 0.2-0.3 μg·kg^-1·h^-1 until about half an hour before the end of surgery.And in patients of tramadol group（Group T）,tramadol 0.6 mg.kg^-1 were infused intravenously, followed by infusion with 1 mg·kg^-1 until about half an hour before the end of surgery.The equal volume of normal saline was given in patients of control group （group C）.The body temperature and sedation score were recorded at the time point of pre-anesthesia（T1）,45 min in operation（T2）,at the end of surgery （T3）.The grades of shivering were recorded.Meanwhile,the adverse reactions,such as nausea,vomitting were observed.Results：There was no difference in body temperature at corresponding time point among three groups（P〉0.05）,but the levels at T2 and T3 were lower than at T1 in any group（P〈0.05）.The sedation scores in group D and Group T were higher than in group C,but the incidences of shivering in group D and Group T were lower than in group C（P〈0.05）.The incidence of nausea and vomitting in group T was higher than in group D and Group C（P〈0.05）.Conclusion： Dexmedetomidine can prevent shivering in transurethral prostatectomy and have more advantages than tramadol.