曲马多治疗椎管内麻醉后寒战60例分析

目的观察曲马多对于椎管内麻醉后寒战的疗效及安全性。方法椎管内麻醉(硬膜外或腰麻-硬膜外联合麻醉)下行腹部或下肢手术、麻醉后出现不同程度寒战(1～3级)60例,ASAⅠ～Ⅲ级,随机分为3组,分别给予曲马多1mg/kg(组Ⅰ)、1.5mg/kg(组Ⅱ)、2mg/kg(组Ⅲ)静脉注射,观察寒战停止的时间、对血压(MAP)、心率(HR)、脉搏血氧饱和度(SpO2)的影响、副作用及寒战的复发等。结果治疗效果满意,总有效率为95%;MAP、HR、SpO2均无明显影响,6例(15%)患者出现恶心、欲吐,5例患者诉头晕,经对症处理后,症状消失;另有13例患者出现复发寒战,再次给予曲马多1～2mg/kg后均于1～3min内寒战停止。结论曲马多对于椎管内麻醉后出现的寒战,疗效显著,且对呼吸、循环无明显影响,安全性高,尤其适用于老年、高危患者及门诊手术中出现寒战的治疗。

Effect of Tramadol hydrochloride on shivering after intravertebrial anesthesia in 60 cases

Objective To observe the efficacy and safety of Tramadol hydrochloride in shivering treatment after intravertebrial anesthesia.Methods Sixty ASAⅠ ～ Ⅲ patients scheduled for abdominal or lower limb surgery undergoing epidural or combined spinal-epidural anesthesia,were all suffered from shivering（graded 1 ～ 3） after anesthesia,randomized to 3 groups by the doses of tramadol：1 mg/kg（group Ⅰ）,1.5 mg/kg（groupⅡ）,2 mg/kg（group Ⅲ）.The time of shivering ceasing,mean artery blood pressure（MAP）,heart rate（HR）,saturation of pulse oxymetery（SpO2） 、side effects and shivering recurs were observed.Results Shivering ceased in 95% patients after Tramadol hydrochloride,MAP、HR、SpO2 were stable.Nausea occurred in 6 patients（15%）,5 patients complained with dizziness,the syndromes were ceased after treated.The shivering were recurred in 13 patients,and ceased by 1 ～ 2 mg/kg Tramadol iv in 1 ～ 3 minutes.Conclusion The treatment of tramadol hydrochloride in shivering after intravertebrial anesthesia are effective,when used in shivering treatment in elderly or outpatients is better than other opiums.