Effect of warm bladder irrigation fluid for benign prostatic hyperplasia patients on perioperative hypothermia, blood loss and shiver: A meta-analysis

Objective:To find out whether warm bladder irrigation fluid can decrease the occurrence of perioperative hypothermia,blood loss and shiver in patients treated with benign prostatic hyperplasia(BPH).Method:A comprehensive literature review and meta-analysis that included randomized controlled trials(RCTs)related to temperature of irrigation fluid in the perioperative treatment for BPH was taken by researchers.The relevant literature were searched in Chinese database,such as Retrieval Chinese Journal Full-text Database,VIP Journal Database,Wanfang database,as well as in English search engine and database,including Embase,Cochrane and Medline till January 2018.The study quality was assessed by recommended standards from Cochrane Handbook(version 5.1.0).Results:A total of 28 RCTs and 3858 patients were included.The results showed that the incidences of shiver(risk ratio[RR]Z 0.32,95%confidence interval[CI]:0.28e0.36,p<0.001,I^2 Z 0%)and hypothermia(RR Z 0.36,95%CI:0.21e0.59,p<0.001,I^2 Z 67%)in the group of warm irrigation fluid were lower than the group having room-temperature fluid.Room-temperature irrigation fluid group caused a greater drop in body temperature compared to warm irrigation fluid group(p<0.001,I^2 Z 96%).We performed a narrative descriptive statistics only because of substantial heterogeneity.Conclusions:Warm bladder irrigation fluid can decrease the drop of body temperature and the incidence of hypothermia and shiver during and after the operation for BPH.Warm irrigation fluid should be considered as a standard practice in BPH surgeries.

Neuraxial adjuvants for prevention of perioperative shivering during cesarean section: A network meta-analysis following the PRISMA guidelines

BACKGROUND Perioperative shivering is clinically common during cesarean sections under neuraxial anesthesia,and several neuraxial adjuvants are reported to have preventive effects on it.However,the results of current studies are controversial and the effects of these neuraxial adjuvants remain unclear.AIM To evaluate the effects of neuraxial adjuvants on perioperative shivering during cesarean sections,thus providing an optimal choice for clinical application.METHODS A systematic review and network meta-analysis were conducted following the PRISMA (Preferred Reported Items for Systematic Review and Meta-analysis) guidelines.Analyses were performed using Review Manager 5.3 and Stata 14.0.We searched PubMed,EMBASE,Web of Science,and Cochrane Central databases for eligible clinical trials assessing the effects of neuraxial adjuvants on perioperative shivering and other adverse events during cesarean sections.Perioperative shivering was defined as the primary endpoint,and nausea,vomiting,pruritus,hypotension,and bradycardia were the secondary outcomes.RESULTS Twenty-six studies using 9 neuraxial adjuvants for obstetric anesthesia during caesarean sections were included.The results showed that,compared with placebo,pethidine,fentanyl,dexmedetomidine,and sufentanil significantly reduced the incidence of perioperative shivering.Among the four neuraxial adjuvants,pethidine was the most effective one for shivering prevention (OR = 0.15,95%CI: 0.07-0.35,surface under the cumulative ranking curve 83.9),but with a high incidence of nausea (OR = 3.15,95%CI: 1.04-9.57) and vomiting (OR = 3.71,95%CI: 1.81-7.58).The efficacy of fentanyl for shivering prevention was slightly inferior to pethidine (OR = 0.20,95%CI: 0.09-0.43),however,it significantly decreased the incidence of nausea (OR = 0.34,95%CI: 0.15-0.79) and vomiting (OR = 0.25,95%CI: 0.11-0.56).In addition,compared with sufentanil,fentanyl showed no impact on haemodynamic stability and the incidence of pruritus.CONCLUSION Pethidine,fentanyl,dexmedetomidine,and sufentanil appear to be effective for preventing perioperative shivering in puerperae undergoing cesarean sections.Considering the risk-benefit profiles of the included neuraxial adjuvants,fentanyl is probably the optimal choice.

Comparative effect of intrathecal meperidine,tramadol,magnesium sulfate,and dexmedetomidine on preventing post-spinal anesthesia shivering and adverse events in hip fracture repair patients:A randomized clinical trial

Objective:To compare effect of intrathecal meperidine,tramadol,magnesium sulfate,and dexmedetomidine on the prevention of post-spinal anesthesia shivering and adverse events in hip fracture repair patients.Methods:In a randomized,double-blind trial,132 patients with American Society of Anesthesiology(ASA)ⅠandⅡspinal anesthesia who needed hip fracture surgery were enrolled.Patients were stratified into 4 intervention groups based on a randomized block pattern:meperidine,tramadol,magnesium sulfate,and dexmedetomidine.Hemodynamic parameters including blood pressure,heart rate,and oxygen saturation,as well as the severity of shivering,core body temperature,Ramsay sedation score,adverse events,meperidine consumption were recorded and compared.Results:There was no statistically significant difference in the normal hemodynamic parameters,temperature,duration of surgery,meperidine consumption,and adverse events such as dizziness,hypotension,nausea,and bradycardia among groups(P>0.05).Compared to other groups,severity of shivering was the lower in the dexmedetomidine group 6 and 8 h after surgery.The Ramsay sedation scores were higher in the dexmedetomidine and meperidine groups 4 h after surgery(P=0.020).Conclusion:Dexmedetomidine acts better than the other three adjuvants in reducing complications such as shivering.Overall,these four adjuvants are helpful to prevent postoperative shivering and could be put forward as promising local anesthetics in spinal anesthesia,based on anesthesiologists’discretion and patients’general conditions.Clinical registration:The study was approved by the Research and Ethics Committee at the Valiasr Hospital(Arak,Iran)with the clinical trial code of IRCT20141209020258N153.

Prophylactic Effect of Oral Clonidine and Tramadol in Postoperative Shivering in Lower Abdominal Surgery

Background and Objectives: Several drugs and methods are used to reduce postoperative shivering, the most common complications occurring after surgery. This study aimed to evaluate the effects of the oral Clonidine and Tramadol premedication in reducing postoperative shivering after spinal anesthesia. Materials and Methods: In this study, patients aged 20 - 60 years, based on the American Society of Anesthesia functional class I (Anesthesiologists grade-1), were included in controlled double-blind clinical trials. Each was a candidate of a hydrocele, varicocele, and inguinal hernia under spinal anesthesia. The patients were assigned to three groups and 1 h prior to surgery, group A received 0.2 mg of Clonidine, group B received 50 mg of a Tramadol tablet, and group C received a placebo. We collected information on the severity of shivering, pain intensity levels (VAS score), duration of analgesia, and the patients’ hemodynamic condition at base time of 5, 15, and 30 min and 1, 2, 4, and 6 h postoperatively. Results: The incidence of shivering was significantly lower in the Clonidine group than that in the other groups. Analgesia duration was significantly longer in the Clonidine group than that in the control group. In this study, side effects in different groups were not significantly different from each other. Conclusion: Results of this study showed that the oral administration of Clonidine can be effective in preventing the side effects and shivering after spinal anesthesia.

Efficacy of Intravenous versus Intrathecal Meperidine on Post-Spinal Shivering after Knee Arthroscopy: A Randomized Controlled Study

Background and Aims: Hypothermia is considered a common problem with anesthesia. Spinal anesthesia, affects the process of temperature regulation. The aim of this study was to compare the prophylactic effect of intravenous (IV) meperidine with intrathecal (IT) meperidine on the prevention of shivering during spinal anesthesia in patients underwent knee arthroscopy. Aim of the Study: The aim of this work is to study the effect of meperidine either intravenous (IV) vs intrathecal (IT) on controlling postoperative shriving after knee arthroscopy. Materials and Methods: This study will be conducted in accordance with the principles of the ethics committee Benha University hospitals. Full written informed consent will be obtained from all patients before inclusion in the study, and a prospective randomized double-blinded study was conducted in adult patients undergoing knee arthroscopy under spinal anesthesia. Cases are divided into three equal groups (20 patients in each). Group IT: will receive spinal anesthesia (12.5 mg heavy bupivacaine) with intrathecal meperidine (25 mg). Group IV: will receive spinal anesthesia (12.5 mg heavy bupivacaine) with intravenous meperidine (25 mg). Group C: will receive spinal anesthesia (12.5 mg heavy bupivacaine) only postoperatively. Incidence and degree of shivering (SS), sedation score (RSS), pain score (VAS), hemodynamics, and PONV will be measured at the following intervals: 0 min (once arrived at PACU), 20 min later, 40 min later, 80 min later. Results: Shivering was observed in 0%, 0%, and 10.5% of patients in Groups IT, IV, and C, respectively. There was a significant difference between Group IT and IV compared to Group C (P Conclusion: We concluded that IT meperidine and IV meperidine comparably can decrease intensity and incidence of shivering compared to control group as well as decrease the requirement for additional doses of meperidine for shivering control without any hemodynamic side effect. And intrathecal meperidine showed better postoperative pain control and less postoperative nausea and vomiting (PONV).

Comparison of Dezocine and Tropisetron for the Control of Maternal Shivering Undergoing Spinal Anesthesia--A Randomized Double-blind Trail

To compare intravenous Dezocine Tropisetron in reatment of shivering after spinal anesthesia in cesarean. A double-blind trail. From January to June 2014 90 cases elective cesarean under spinal anesthesia randomly divided into three groups of 30, the control group A （Sml saline） given to dezocine （10mg / 5ml） B grou, given tropisetron （5mg / 5ml） C group. The incidence of shivering in groups 46.48%, 31.18%, 60.83% （P = 〈0.01）. Bradycardia is a group （A） 3.3%, the group （B） is 0.0%. Significant differences in other variables （myoclonic seizures and rash） no significant （P = 0.353）. Dezocine and Tropisetron alone can cure shivering effectively for cesarean section after spinal anesthesia.

右美托咪定对孕产妇椎管内麻醉期间寒战及血流动力学的影响

目的 探讨右美托咪定对孕产妇行椎管内麻醉期间寒战及血流动力学的影响。方法 纳入384例术中发生寒战的剖宫产产妇并随机分为观察组和对照组,各192例。对照组采用哌替啶对寒战进行治疗,观察组采用右美托咪定。比较2组麻醉效果、寒战治疗的疗效、血流动力学指标及血清中超敏C反应蛋白(hs-CRP)、前列腺素E2(PGE2)、皮质醇(Cor)水平。结果 相较于对照组,观察组的寒战停止时间较短,寒战控制情况较好(P<0.05);2组舒张压、收缩压、心率、血氧饱和度均发生改变,但观察组波动幅度显著小于对照组(P<0.05);2组应激指标均升高,但观察组hs-CRP、PGE2、Cor水平较对照组升高幅度小(P<0.05);观察组不良反应总发生率低于对照组(P<0.05)。结论 临床应用右美托咪定对剖宫产产妇进行椎管内麻醉治疗寒战的效果较好,可稳定机体血流动力学水平,临床应用价值较高。

正念减压训练结合纽曼系统干预在肝癌手术患者中的应用

目的 探讨正念减压训练结合纽曼系统干预在肝癌手术患者中的应用效果。方法 将135例肝癌手术患者按随机数字表法分为观察组、对照A组、对照B组,每组45例。对照A组采取正念减压训练,对照B组采取纽曼系统干预,观察组采取正念减压训练结合纽曼系统干预。比较3组患者术后康复情况、心理状态[简式简明心境问卷(POMS-SF)]、创伤后应激障碍[创伤后应激障碍自评量表(PCL-C)]及术后寒战发生情况。结果 观察组患者术后首次排气时间、首次排便时间、首次进食时间、首次下床时间及术后住院时间均短于对照A组、对照B组,差异均有统计学意义(P﹤0.05)。干预后,观察组、对照A组患者POMS-SF量表各维度评分均较干预前降低,且观察组患者POMS-SF量表各维度评分均低于对照A组、对照B组,对照A组患者POMS-SF量表各维度评分均低于对照B组,差异均有统计学意义(P﹤0.05)。干预后,3组患者PCL-C量表各维度评分均较干预前降低,且观察组患者PCL-C量表各维度评分均低于对照A组、对照B组,差异均有统计学意义(P﹤0.05)。观察组、对照B组患者术后寒战发生率均低于对照A组,差异均有统计学意义(P﹤0.05)。结论 正念减压训练结合纽曼系统干预有助于调节肝癌手术患者的心理状态,减轻创伤后应激障碍,减少术后寒战,促进术后早期康复。

冷应激下褐色脂肪细胞线粒体生物发生研究进展

褐色脂肪组织(BAT)主要由褐色脂肪细胞(BA)组成,普遍存在于哺乳动物体内,是冷应激环境下非颤栗产热(NST)的主要能量来源,可以通过线粒体生物发生产热过程调节机体能量平衡,对维持体温至关重要。为更深层次地了解冷应激下BA线粒体生物发生过程,本文综述了冷应激下BA产热的作用、腺苷酸活化蛋白激酶(AMPK)信号通路诱导线粒体生物发生机理等以及线粒体生物发生与线粒体自噬之间对BA线粒体生物发生产热影响的研究进展,可为通过降低家畜机体维持能量提高寒冷地区家畜生产性能和生产效益提供理论依据。

预防低体温的模块化护理在老年前列腺手术患者中的应用

目的探讨预防低体温的模块化护理在老年前列腺手术患者中的应用效果。方法选取2023年2月至12月南京医科大学附属淮安第一医院收治的130例老年良性前列腺增生患者,按随机数字表法将其分为对照组和观察组,每组65例。对照组给予常规保温护理,观察组在对照组基础上给予预防低体温的模块化护理。比较两组入手术室(T_(1))、麻醉后0.5 h(T_(2))、麻醉后1 h(T_(3))、手术结束时(T_(4))体温;统计两组术中寒战、膀胱痉挛和低体温发生情况及患者满意度;比较两组护理前后睡眠质量和舒适度。结果整体分析发现:两组体温的组间比较、时间点比较及交互作用,差异均有统计学意义(P<0.05)。组内比较:两组T_(2)、T_(3)、T_(4)时点体温均低于T_(1)时点,T_(3)、T_(4)时点体温均低于T_(2)时点,T_(4)时点体温均低于T_(3)时点,差异有统计学意义(P<0.05);组间比较:观察组T_(1)、T_(2)、T_(3)、T_(4)时点体温均高于对照组,差异有统计学意义(P<0.05)。观察组术中寒战轻于对照组,膀胱痉挛、低体温发生率均低于对照组,差异有统计学意义(P<0.05)。护理后,两组匹兹堡睡眠质量指数(PSQI)评分均低于护理前,Kolcaba舒适状况量表(GCQ)评分均高于护理前,且观察组PSQI评分低于对照组,GCQ评分高于对照组,差异有统计学意义(P<0.05)。观察组满意度优于对照组,差异有统计学意义(P<0.05)。结论老年良性前列腺增生患者应用预防低体温的模块化护理可有效降低术中寒战、膀胱痉挛和低体温的发生风险,提高患者睡眠质量、舒适度及满意度。

0.1mg/kg纳布啡对腰-硬联合麻醉剖宫产产妇血流动力学、术后疼痛及寒战的影响

目的:探讨0.1 mg/kg纳布啡对腰-硬联合麻醉剖宫产产妇血流动力学、术后疼痛及寒战的影响。方法:选择2021年4月—2023年4月泉州市第一医院接收的拟行剖宫产产妇100例作为研究对象,术中采取腰-硬联合麻醉,采用随机数字表法分为观察组和对照组,各50例。观察组在胎儿娩出后夹闭脐带即刻静注0.1 mg/kg纳布啡,对照组注入等容量0.9%氯化钠溶液。比较两组麻醉前、用药即刻、用药30 min及用药6 h的血流动力学指标,比较两组Ramsay镇静评分、视觉模拟评分法(VAS)评分,比较两组寒战发生情况及用药后不良反应发生情况。结果:麻醉前、用药即刻,两组HR、MAP、SpO2比较差异均无统计学意义(P>0.05);与麻醉前相比,用药即刻两组HR、MAP、SpO2均明显降低(P<0.05);与用药即刻比较,用药30 min、6 h时观察组HR、MAP差异均无统计学意义(P>0.05),SpO2均明显升高(P<0.05);对照组HR、MAP均明显升高(P<0.05),SpO2比较差异均无统计学意义(P>0.05);用药30 min、6 h时观察组HR、MAP均低于对照组,SpO2均高于对照组(P<0.05)。观察组Ramsay镇静评分情况和VAS评分情况均优于对照组(P<0.05)。观察组寒战发生情况优于对照组(P<0.05)。观察组用药后不良反应发生率为8.00%,与对照组14.00%比较,差异无统计学意义(P>0.05)。结论:腰-硬联合麻醉剖宫产胎儿娩出后即刻静注0.1 mg/kg纳布啡维持产后稳定的血流动力学,并可进一步提高镇静、镇痛效果,有效预防和减轻术后寒战,而且用药不良反应少,安全性高。

剖宫产术中产妇发生寒战的影响因素分析

目的:探究剖宫产产妇术中发生寒战发生影响因素。方法:回顾性收集2021年1月-2023年12月本院产科收治的剖宫产产妇360例,采用寒战分级(BSAS)将产妇分为寒战组与非寒战组,运用单因素和多因素logistic分析法分析术中寒战的响因素。结果:360例术中发生寒战87例(24.2%),寒战组与非寒战组年龄、分娩前体质指数(BMI)、禁食时间、经产妇、急诊入院、麻醉方法、入室至麻醉成功时间、手术时间、失血量、术中输液量、输入液体温度、使用加温毯、使用右美托咪啶/艾司氯胺酮、焦虑自评量表(SAS)、抑郁自评量表(SDS)、产科急症、胎儿窘迫/新生儿窒息等均有差异(P<0.05)。多因素logistic分析显示,年龄大、禁食时间长、急诊入院、椎管内麻醉、入室至麻醉成功时间长、手术时间长、失血量大、术中输液量大、输入液体温度低、SAS高、SDS高、产科急症、胎儿窘迫/新生儿窒息失血量多均为寒战发生危险因素,分娩前BMI、经产妇、使用加温毯、使用右美托咪啶/艾司氯胺酮为保护因素(均P<0.05)。结论:剖宫产产妇术中寒战发生率较高,影响因素也较多,应针对影响因素积极防治,以降低发生率,提高手术安全性。

行TEP老年患者实施复合保温护理干预对术中应激反应指标和低体温及寒战发生率的影响

目的:探讨行完全腹膜外腹腔镜疝修补术(TEP)老年患者实施复合保温护理干预对术中相关应激反应指标和低体温及寒战发生率的影响,为临床护理提供依据。方法:选取2020年1月—2022年1月德阳市人民医院手术室行TEP的98例老年患者作为研究对象,采用随机数表法将其分为常规组与研究组,每组各49例。常规组采用常规性保温护理干预,研究组在常规性保温护理基础上给予复合保温护理干预。比较两组患者手术前后各时间点相关应激反应指标(收缩压、心率)、体温变化、低体温和寒战发生率情况。结果:手术后,研究组患者手术后30min、手术结束时收缩压和心率均低于常规组,差异有统计学意义(t=6.274、4.067、5.736、5.952、P<0.05)。手术后,研究组患者术手后30min、手术结束时体温均高于常规组,差异有统计学意义(t=12.543、10.625,P<0.05)。研究组患者术中低体温及寒战发生率均低于常规组,差异有统计学意义(χ^(2)=5.018、5.995,P<0.05)。结论:对行TEP老年患者实施复合保温护理干预,能够改善患者术中相关应激反应指标,降低患者术中低体温及寒战发生风险。

体温控制联合麻醉苏醒干预对腹腔镜全麻手术患者术后认知功能及恢复期寒颤的影响

目的 探讨体温控制联合麻醉苏醒干预对腹腔镜全麻手术患者术后认知功能及恢复期寒颤的影响。方法 选择2019年7月至2022年6月收治的腹腔镜全麻手术患者94例,根据护理干预方式不同分为对照组和观察组,每组47例。对照组给予常规干预;观察组采用体温控制联合麻醉苏醒干预,对比2组患者围术期应激反应情况。采用蒙特利尔认知评估(MoCA)和简易精神状态检查(MMSE)量表评价术前及术后2组患者的认知功能情况。比较2组患者术后寒颤情况。比较2组满意度情况。结果 术后,2组C-反应蛋白(CRP)、肾上腺素、去甲肾上腺素高于术前,对照组明显高于观察组(P<0.05);术后,2组MoCA和MMSE评分低于术前(P<0.05),对照组明显低于观察组(P<0.05);观察组寒颤分级和满意度均明显优于对照组(P<0.05)。结论 体温控制联合麻醉苏醒干预可减轻腹腔镜全麻手术患者应激反应,降低术后认知功能障碍,有效预防恢复期寒颤,利于患者术后转归。

老年患者下肢骨折术中保温干预对术后寒战、隐性失血发生率的影响

目的探究在老年下肢骨折术中实施术中保温对术后寒战、隐性失血的影响,为治疗该类病症提供方法。方法选取2021年3月-2023年1月在中国人民解放军联勤保障部队第九六四医院行手术治疗的108例老年下肢骨折患者,随机数字表法分成对照组与观察组,每组54例,术中2组患者分别进行常规干预与保温干预。分别于入室(T0)、开始手术(T1)、术中30 min(T2)、术中60 min(T3)、结束手术(T4)测量患者体温,比较2组凝血功能、临床指标及寒战发生状况。结果T1 T4时刻,2组体温变化时间、组间及交互差异显著(P<0.05)。手术后,观察组凝血活酶时间、凝血酶原时间、凝血酶时间及纤维蛋白原水平均低于对照组,血小板计数水平高于对照组(P<0.05);观察组术中出血、隐性失血及切口引流量与寒战发生率均低于对照组,热舒适度评分显著高于对照组(P<0.05),2组输血例数无显著差异(P>0.05)。结论对老年下肢骨折患者进行术中保温干预效果较好,能有效预防术后寒战的发生,保持机体凝血功能稳定,减少隐性失血量,具有一定临床价值。

手术室体温护理在行腹腔镜结直肠癌根治术患者中的应用效果

目的:观察手术室体温护理在行腹腔镜结直肠癌根治术患者中的应用效果。方法:选取2020年10月—2022年10月于北京市健宫医院行腹腔镜结直肠癌根治术的150例患者作为研究对象,根据随机数字表法分为两组,各75例。对照组采用常规护理模式,试验组在对照组基础上实施手术室体温护理。比较两组苏醒时间与肠道恢复时间、体温、应激指标、寒战发生情况、护理满意度。结果:试验组术后苏醒时间与肠道恢复时间早于对照组,差异有统计学意义(P<0.001)。手术前,两组体温比较,差异无统计学意义(P>0.05);手术开始后1 h、手术结束时,对照组体温低于手术前及同期试验组,差异有统计学意义(P<0.05)。术后,两组心率、收缩压、舒张压水平高于术前,但试验组低于对照组,差异有统计学意义(P<0.05)。试验组寒战发生率低于对照组,护理满意度评分高于对照组,差异有统计学意义(P<0.05)。结论:手术室体温护理在行腹腔镜结直肠癌根治术患者中的应用效果显著,可促进患者恢复,稳定患者体温,降低寒战发生率,减轻应激反应,提高护理满意度。

羟考酮防治围手术期寒战的研究进展

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。

氟比洛芬酯对行根治性胃切除的患者围术期体温及寒颤的影响

目的 探讨氟比洛芬酯对行根治性胃切除的患者围术期体温及寒颤的影响。方法 将2020年1月至2021年12月送入商丘仁和中医院院接受根治性胃切除手术治疗的120例患者作为研究对象,依据随机数表法分为对照组60例,观察组60例。在干预方案的实际过程中,对照组剔除5人。观察组患者剔除4人。最终完成本次研究的,对照组55人,观察组56人。麻醉诱导后对照组给予0.9%生理盐水10 mL进行静脉输注,观察组给予氟比洛芬酯100 mg进行静脉输注。对比两组患者的麻醉药物用量及手术相关用时,患者入室时(T1),进入恢复室时(T2),出恢复室时(T3)的平均动脉压、心率、耳膜温度,对比两组患者在恢复室期间的寒颤发生情况及患者拔管后0.5 h及1 h的疼痛严重程度[视觉模拟评分法(VAS)],对比两组拔管后1 h内的不良反应发生情况。结果 两组患者的舒芬太尼使用量、瑞芬太尼使用量、麻醉持续时间、手术持续时间、术后拔管时间差异均无统计学意义(P> 0.05)。两组患者T1、T2、T3的平均动脉压,心率,耳膜温度差异均无统计学意义(P> 0.05)。观察组在恢复室期间的寒颤发生率低于对照组,观察组在恢复室期间的寒颤发生分级低于对照组,差异具有统计学意义(P <0.05)。两组寒颤持续时间差异无统计学意义(P> 0.05)。观察组患者拔管后0.5 h及1 h疼痛严重程度均低于对照组,差异具有统计学意义(P <0.05)。两组拔管后1 h的恶心、呕吐发生率差异无统计学意义(P> 0.05)。结论 行根治性胃切除的患者个体中,在麻醉诱导后给予氟比洛芬酯100 mg进行静脉输注,可以明显的降低手术后寒颤的比例以及严重程度,同时可降低术后的疼痛程度,且用药方法不会对循环系统构成影响,不会额外增加不良反应。

小剂量右美托咪定对子宫下段剖宫产术中寒战和牵拉反应的影响

目的探讨小剂量右美托咪定对子宫下段剖宫产术中寒战和牵拉反应的影响。方法选取2022年2月至2024年2月于广东祈福医院行腰硬联合麻醉下子宫下段剖宫产术的60例产妇作回顾性分析,根据胎儿娩出后有无静脉注射右美托咪定分为试验组与对照组,每组各30例。试验组在胎儿娩出后静脉注射右美托咪定0.25μg/kg,注射时间>5min,对照组注射等量生理盐水。比较两组寒战、牵拉反应及不良反应发生情况。结果试验组寒战总发生率低于对照组(P<0.05)。试验组牵拉反应优良率高于对照组(P<0.05)。两组均未发生心动过缓、低血压等不良反应。结论小剂量右美托咪定能降低子宫下段剖宫产术中寒战的发生率,减轻牵拉反应,且不增加不良反应。

艾司氯胺酮诱导预防烧伤患者术后寒战的研究

目的观察艾司氯胺酮诱导预防烧伤患者术后寒战的效果。方法选择2021年5月至2022年6月浙江中医药大学附属嘉兴中医医院行烧伤削痂手术患者57例。采用随机数字表法分为研究组29例和对照组28例。研究组给予艾司氯胺酮0.5 mg/kg麻醉诱导,对照组给予芬太尼4μg/kg麻醉诱导。记录并比较两组患者诱导前、诱导后5 min、拔管后5 min的心率(HR)、平均动脉压(MAP)以及诱导前、拔管后5 min的体温,计算体温差;观察两组患者术后寒战严重程度以及不良反应发生情况。结果研究组诱导后5 min的MAP、HR及拔管后5 min的MAP均高于对照组,拔管后5 min的体温与诱导前的体温差小于对照组,差异均有统计学意义(均P<0.05)。研究组术后寒战发生率为24.14%(7/29),低于对照组的53.57%(15/28),差异有统计学意义(P<0.05)。研究组术后发生恶心、呕吐1例,对照组为7例,两组患者恶心、呕吐比较差异有统计学意义(P<0.05)。结论艾司氯胺酮诱导可有效减少烧伤患者术后寒战的发生,且降低术后不良反应发生率。