异泊酚与右美托咪定在治疗剖宫产术硬膜外麻醉后寒战的对比研究

目的 评价异丙酚与右美托咪啶对剖宫产术硬膜外麻醉后寒战的治疗作用.方法 87例择期在硬膜外麻醉下行剖宫产术孕妇,ASA Ⅰ～Ⅱ级,随机分为对照组（C组）27例、异丙酚组（P组）31例、右美托咪定组（D组）29例.当发生寒战时,C组泵入生理盐水,D组予右美托咪定1 μg/（kg·10min）,10min后以0.3μg/（kg·h）继续静脉泵注,P组泵注异丙酚1mg/（kg·min）,而后以3mg/（kg·h）继续静脉泵,各组总注药时间均为20min.监测各组生命体征变化,观察麻醉后寒战发生率及程度.结果 3组患者一般情况、围术期循环和呼吸变化差异均无统计学意义（P＞0.05）,在所有被观察的病例中寒战发生率达50.3％,P、D组与C组相比均可明显减轻寒战的等级与持续时间（P＜0.05）,与D组比较,P组寒战更快消失,其差异有统计学意义（P＜0.05）.结论 异丙酚与右美托咪定均可安全有效地预防剖宫产硬膜外麻醉后的寒战反应,但异丙酚起效更快.

Comparative Study of Shivering after Spinal Anesthesia in Cesarean Section Treated by Propofol and Dexmedetomidine

Objective To evaluate the effects of propofol and dexmedetomidine in the treatment of shivering in cesarean section after epidural anesthesia.Methods 87 cases undergoing elective in epidural anesthesia for cesarean section pregnant women,ASA Ⅰ-Ⅱ,were randomly divided into C （control group） of 27 cases,P （propofol Group） of 31 cases,D （dexmedetomidine group） of 29 cases.When the chill happened,Patients in group C pump into the saline,D group received dexmedetomidine 1 μg/（kg · 10min）,10min later with 0.3μg/（kg · h） continue to pump,P group received propofol 1mg/（kg · min）,1min later with 3mg/（kg · h） to vein pump.Total injection time of each group was 20min.The changes of vital signs,the incidence and degree of shivering after anesthesia were monitored.Results Patients of the 3 groups in general,confining difference circulatory and respiratory changes had no statistical significance （P ＞0.05）.Shivering occurred rate in all cases was 50.3％.P,D group and C group had significant reduced chills level and duration （P ＜0.05）,compared with group D.Chil in P group disappeared faster,and the difference was statistically significant （P ＜ 0.05）.Conclusion Propofol and dexmedetomidine can be safely and effectively in preventing cesarean section of shiyering after epidural anesthesia,but propofol can be faster.