加温输液复合术中镇静对腰硬联合麻醉下剖宫产术中寒战反应的临床研究

目的探讨加温输液复合术中镇静对腰硬联合麻醉下行剖宫产产妇术中寒战反应的影响。方法将腰硬联合麻醉下择期行剖宫产手术的健康初产妇90例随机分为3组,各30例。Ⅰ组术中输注未经特殊处理的液体,Ⅱ、Ⅲ组术中输注预先加温至37℃的液体;胎儿娩出断脐后即刻Ⅰ、Ⅱ组静脉注射生理盐水5 mL,Ⅲ组静脉注射咪达唑仑0.04 mg/kg(生理盐水稀释至5 mL)。观察三组产妇寒战的发生情况。结果Ⅱ、Ⅲ组寒战总发生率和2级寒战发生率低于Ⅰ组,差异有统计学意义(P<0.05)。结论加温输液和加温输液复合术中镇静均能减轻腰硬联合麻醉下行剖宫产术中产妇寒战的发生率,但加温输液复合术中镇静更为有效。

Warming Intravenous Fluids Combined with Intraoperative Sedation Alleviation of Shivering during Cesarean Delivery under Combined Spinal-epidural Anaesthesia

Objective To research the effects of warming intravenous fluids combined with intraoperative sedation on shivering during cesarean delivery.Methods 90 parturients scheduled for nonemergent cesarean delivery were randomly allocated to 3 groups(30 cases in each group).Patients in group Ⅰ received unwarmed fluids,patients in group Ⅱ and Ⅲ received pre-warmed fluids(37 ℃)throughout the intraoperative period.After fetal birth,anesthesiologist injected intravenously normal saline 5 mL in groupⅠ,Ⅱand midazolam 0.04 mg/kg(diluted to 5 mL with normal saline)in group Ⅲ.Shivering reaction of parturients was observed.Results The overall incidence of chills of group Ⅱ and Ⅲ was lower than group Ⅰ with statistically significant difference(P<0.05).Conclusion Warming intravenous fluids and warming intravenous fluids combined with intraoperative sedation can both reduce the incidence and severity of shivering of parturients during cesarean delivery under combined spinal-epidural anaesthesia,and the combined application is more effective.