麻醉前静注长托宁预防剖宫产围术期寒颤的临床研究

目的探讨麻醉前预防性静注长托宁对剖宫产围术期寒颤的作用。方法80例择期在腰硬联合麻醉下行剖宫产的产妇,ASAⅠ~Ⅱ级,随机分为两组,每组产妇均为40例。术前Ⅰ组静脉注射长托宁1mg,Ⅱ组静脉注射0.5mg阿托品。持续监测围术期呼吸、循环的变化,测定麻醉阻滞平面,记录胎儿出生后的Apgar评分,观察记录产妇寒颤发生情况。结果两组产妇一般情况相同(p>0.05);两组产妇围术期呼吸变化差异无显著性(p>0.05);两组产妇在用药前后MAP均无明显变化(p>0.05),Ⅰ组用药前后HR变化差异无显著性(p>0.05),Ⅱ组用药后HR上升明显,差异有显著性(p<0.05);Ⅰ组有轻度寒颤4例,发生率为10%,Ⅱ组有轻度寒颤7例,重度寒颤5例,发生率为30%。结论长托宁用于预防围术期寒颤优于阿托品,且不良反应小,值得临床推广应用。

THE CLINICAL RESEARCH OF PENEHYCLIDINE HYDROCHLORIDE INJECTED BEFORE ANESTHESIA TO PREVENT THE PERIOPERATIVE SHIVERING OF CESAREAN SECTION

Objective Study the effect of Penehyclidine Hydroehloride injected before anesthesia to prevent the pcrioperative shivering of cesarean section. Methods 80 puerperants undergoing elective cesarean section in combined spinal - epidural anesthesia （ CSEA）, ASA Ⅰ-Ⅱ , were randomly divided into two groups, 40 in each group. GroupⅠ was given Penehyelidine Hydrochloride lmg before operation. Group Ⅱ was given atropine 0.5rag before operation. Continuous monitoring the change of respiratory -circulatory, determining the level of anesthesia, recording neonatal Apgar score, observing and recording oecurenee conditions of shivering. Results There was no remarkable difference in two group puerperants＇ general condition （p 〉 0.05） ; There was no remarkable difference in two group puerperants＇ change of respiratory（p 〉0.05） ; There were no remarkable difference in two group puerperants＇ change of MAP （p 〈0.05）. There were no remarkable difference in the change of HR in group Ⅰ ; And HR was increasing remarkably in group Ⅱ ; 4 puerperants had slightly shivering in Group Ⅰ , incidence is 10%. 7 puerperants had slightly shivering and 10 had severely shivering in group , incidence is 30%. Conclusion Penehyclidine Hydrochloride is better than atropine in preventing perioperative shivering, and have less adverse reaction. So deserves further clinical applications