硬膜外麻醉中发生寒战的原因分析

目的:探讨硬膜外麻醉中发生寒战的相关原因。方法:将硬膜外麻醉腹部手术200例随机分为两组。A组:夏季患者100例,室温25～30℃;B组:冬季患者100例,室温20～25℃。结果:发生寒战76例,总发生率38%。其中,A组18例(18%),B组58例(58%)例,B组发生率明显高于A组,两组有显著性差异(χ2=33.96,P<0.01)。60岁以上患者仅发生6例,剖宫产手术发生寒战例数较多。结论:硬膜外麻醉寒战主要与室温降低、冷消毒液直接刺激、局麻药温度低、麻醉阻滞平面过广、年龄、心理等因素有关。目前,单一因素不能解释这一并发症,有关其它因素有待进一步研究。

Cause analysis of shivering in the epidural anesthesia

Objective:To study the causes of shivering in the epidural anesthesia.Methods:200 cases of epidural anesthesia abdominal surgery were randomly divided into two groups.A group: 100 patients in summer,room temperature was 25~30℃;B group: 100 patients in winter,room temperature was 20~25℃.Results:18 patients in the group A happened shivering,58 patients in the group B happened shivering,the incidence rate of group B was significantly higher than group A,there was significant difference(χ2=33.96,P<0.01).There were only 6 cases of occurrence of shivering in patients over the age of 60.There were more cases of occurrence of shivering in caesarean operation.Conclusion:Epidural anesthesia shivering mainly associated with room temperature reduction,cold disinfectant direct stimulation,low temperature of local anesthetic,anesthetic block level too broad,age,psychological factors and other factors.The current single factor can not explain this complication,other factors need to be further studied.