多沙普仑和哌替啶治疗全麻苏醒期寒战的对比研究

目的：研究多沙普仑和哌替啶对于全麻后寒战患者的治疗效果及对苏醒质量的影响。方法将全麻苏醒期进入术后恢复室后发生寒战的51例全麻病人随机分三组治疗：多沙普伦针1.0 mg/kg （多沙普仑组）、哌替啶针0.5 mg/kg（哌替啶组）及0.9％氯化钠注射液（对照组），比较三组患者的降低寒战分级、寒战终止率，并观察对镇静、镇痛的影响及不良反应发生率。结果治疗1 min、2.5 min和5 min后多沙普仑组和哌替啶组寒战等级相比对照组均有明显降低，差异均有统计学意义（H分别=18.97、24.96、30.85，P均＜0.05）。治疗1 min后，多沙普仑组和哌替啶组寒战终止率明显高于对照组，差异均有统计学意义（χ2=5.04、11.10，P＜0.05）。而哌替啶组24 h内恶心、呕吐的发生率明显高于多沙普仑组和对照组，经Fisher精确检验，差异均有统计学意义（P均＜0.05）。三组之间术后恢复室停留时间比较，差异无统计学意义（F=8.63，P＞0.05）。结论全麻术后寒战患者使用多沙普仑和哌替啶都有明显中止寒战效果，哌替啶会增加术后恶心呕吐的发生。对已经苏醒的患者，两药对全麻的恢复无明显影响。

Effect comparison of doxapram and pethidine on postoperative shiver in general anesthesia recovery period

Objective To compare the effect of doxapram and pethidine on postoperative shiver in general anesthesia re-covery period. Methods Fifty-one patients who shivered during recovery from general anesthesia were randomly divided into three groups： doxapram group that received doxapram 1.0mg/kg, pethidine group that received pethidine 0.5 mg/kg and control group that received normal saline. Shiver grade and the rate of shiver stopped were compared. The effect of two drugs on sedation and analgesia and adverse effect incidence were observed. Results At 1, 2.5 and 5 minutes after treat-ment, both doxapram and pethidine groups were significantly effective in reducing postoperative shivering grade comparing with control group （H=18.97,24.96,30.85,P〈0.05）. At 1 minute after treatment, the rate of shiver stopped of both doxapram and pethidine groups were significantly higher than control group （χ2=5.04,11.10,P〈0.05）. But pethidine group had significantly higher incidence of postoperative nausea and vomiting comparing with doxapram or saline at 24 hours（P〈0.05）. There were no statistical difference of stay time in recovery room among the three groups （F=8.63,P〉0.05）. Con-clusion Both doxapram and pethidine were effective for postoperative shiver while pethidine had higher incidence of post-operative nausea and vomiting. The doxapram and pethidine were unaffected general anesthesia recovery when as to already awake patients.