羟考酮防治围手术期寒战的研究进展

Research progress on prevention and treatment of perioperative shivering with oxycodone

寒战是围手术期常见的不良反应,会造成患者恐慌、机体代谢需求增加、低氧血症、酸中毒、生命体征监测干扰等问题。既往临床常使用哌替啶和曲马多等药物防治寒战,但易发生呼吸抑制、恶心呕吐等不良反应。近年有研究发现羟考酮作为μ和κ阿片受体激动剂具有良好的寒战防治功效且不良反应发生率低于传统寒战防治药物。本文结合国内外文献,就寒战病理生理、羟考酮防治寒战机制、效果及最佳剂量、不良反应等方面的研究进展进行综述,旨在为羟考酮防治围手术期寒战提供一定的理论与临床依据。

Shivering is a common adverse reaction in the perioperative period,causing problems such as patient panic,increased metabolic demands on the body,hypoxemia,acidosis,and disturbances in vital sign monitoring.In the past,drugs such as pethidine and tramadol were often used to prevent shivering,but were prone to respiratory depression,nausea and vomiting and other adverse effects.Recent studies have found that oxycodone as aμandκopioid receptor agonist have good efficacy against shivering with a lower incidence of adverse effects than conventional shivering medications.Incorporating the domestic and international literature,this paper presents a review of the research progress on the pathophysiology of shivering,the mechanism,effects and optimal dose of oxycodone in the prevention and treatment of shivering.The aim of this article is to provide some theoretical and clinical basis for the use of oxycodone in the prevention and treatment of perioperative shivering.