硫酸镁对蛛网膜下腔阻滞下行前列腺电切术患者寒战的影响

目的:探讨术中输注硫酸镁对蛛网膜下腔阻滞下行前列腺电切术患者寒战反应的影响。方法:将60例择期在蛛网膜下腔阻滞下行经尿道前列腺切除术的患者随机均分为对照组与治疗组。治疗组在常规麻醉的基础上,30min内经微量泵泵注60mg·kg-1硫酸镁,1.5g·h-1维持;对照组在常规麻醉基础上静脉注射与治疗组相同容量的0.9%氯化钠注射液。采用麻醉药肌松作用评分(Bromage)评估患者运动阻滞程度,通过针刺试验评定感觉阻滞平面,观察蛛网膜下腔阻滞后的寒战反应,并记录不良反应。结果:治疗组所有患者均出现低体温,对照组仅70.0%的患者出现低体温(P<0.05),且治疗组体中心温度下降更显著(P<0.01),但寒战反应的发生率对照组(73.3%)高于治疗组(10.0%,P<0.01)。结论:硫酸镁输注可以明显减轻经蛛网膜下腔阻滞下行经尿道前列腺电切术患者的寒战反应,但同时会增加体温过低的风险。

Effects of Magnesium Sulfate on Shiver in Patients underwent Transurethral Prostatectomy after Subarach- noid Block during Surgery

OBJECTIVE： To investigate the effects of magnesium sulfate infusion on shiver in patients with subarachnoid block during surgery. METHODS： 60 patients scheduled for elective transurethral prostatectomy after subarachnoid block were random- ized into control group and treatment group. Treatment group received an intravenous bolus of magnesium sulfate 60 mg. kg^-1via syringe pump in 30 minutes, followed by a constant pumped infusion of 1.5 g.h-1. Motor blockade was evaluated by bromage mo- tor scale. Sensory block level was assessed by pinprick test. Shiver reaction was assessed after the completion of subarachnoid block and side effects were recorded. RESULTS： Hypothermia was observed in all patients in treatment group and in 70.0% patients in control group （P〈0.05）. The decrease in core temperature in treatment group was more significant than control group （P〈0.01）. The incidence of shiver in control group （73.3%） was higher than in treatment group （10.0%） （P〈0.01）. CONCLUSIONS： Mag- nesium sulfate infusion significantly relieves shiver in patients underwent transurethral prostatectomy after subarachnoid block but in- creases the risk of hypothermia.