布托啡诺不同给药途径治疗剖宫产术中寒战的临床对比观察

目的对比布托啡诺不同给药途径在治疗剖宫产手术中寒战的临床效果及安全性。方法选择椎管内麻醉下择期行剖宫产手术产妇60例,ASAⅠ～Ⅱ级,随机分成三组(n=20)。Z组:布托啡诺椎管组;J组:布托啡诺静脉组;D组:对照组。观察记录局麻药感觉阻滞起效时间;胎儿娩出前5 min(T1)、胎儿娩出后5 min(T2)、胎儿娩出后10 min(T3)、胎儿娩出后30 min(T4)产妇寒战发生率;T2、T3、T4产妇镇静满意率;术中不良反应;胎儿Apgar评分等。结果Z组局麻药起效时间快,T1寒战发生率明显低于J组和D组(P<0.01);Z组和J组T2、T3、T4寒战发生率、镇静效果满意率无明显差异(P>0.05),与D组有明显差异(P<0.01);Z组和J组无不良反应发生;三组胎儿Apgar评分无差异。结论布托啡诺椎管内给药不仅缩短局麻药起效时间,而且全程有效治疗产妇手术中的寒战;镇静效果满意,不良反应小,安全性较高,无局限性,优于静脉给药。

Clinical observation and comparison of different dosing methods of butorphanol in curing shiver during cesarean

Objective To compare the clinical effect and safety about Butorphanol＇s different dosing methods in the treat- ment of cesarean shiver. Methods Sixty puerperae（ASA level Ⅰ～Ⅱ ） who chosed the spinal canal anesthesia and selected cesarean operation were observed randomLy devided into 3 groups （n = 20）：group Z, dosing through spinal canal;gourp J ： dosing through vein ; group D, the control group. The following data are observed and noted down ： 1.The time when the lo- cal anesthetics takes effect;2.Maternal shivers rate between 5 minutes before childbirth （T1）, 5 minutes after birth （T2）, 10 minutes after birth（T3） and 30 minutes after birth （T4） ;3.T2,T3, and T4 puerpera calm satisfaction rate;4.Adverse reaction during operation;5.Fetal Apgar score,etc. Results Local anesthetics （Group Z） works faster than the other two groups, significantly lower shiver incidence during T1 than J group and D group（P 〈 0.01 ） ;group Z and Group J had no obvious difference in cesarean shiver incidence and calm effect satisfaction rate（P 〉 0.05） during T2,T3 ,T4, However Group D was different（P 〈 0.01 ） Z group and J group had no adverse reaction; three groups have same APGAR scores. Conclusion Taking effect much faster,dosing through spinal canal is an efficient therapy for cesarean shiver during the whole operation. It leads to higher satisfaction rate, high security, no limitation and surpasses the Intravenous injection method.