布托啡诺预防硬膜外麻醉下腹部手术中寒战30例

目的 观察布托啡诺在预防硬膜外麻醉下腹部手术中寒战的效果.方法 选取硬膜外麻醉下腹部手术患者90例,随机均分成布托啡诺组(B组)、哌替啶组(D组)、对照组(生理盐水组,C组).记录各组在给药后5,15,30min时的寒战预防效果、生命体征变化以及不良反应的发生情况.结果 B组和D组在用药5 min内寒战预防有效率分别为96.67%和86.67%,两组间比较差异无显著性,但两组分别与对照组比较差异具有显著性(P<0.05);B组和c组在用药前后生命体征指标变化无显著性差异,D组较用药前具有显著性(P<0.05);B组较D组易发生嗜睡(P<0.05),D组较B组更易发生恶心呕吐(P<0.05);3组均无呼吸抑制.结论 布托啡诺与哌替啶对处理硬膜外麻醉下腹部手术后寒战均有显著效果,布托啡诺治疗效果优于哌替啶,但无显著性差异.

Observation on Effects of Butorphanol for Preventing Shivering during Abdominal Operation under Epidural Anesthesia

Objective To observe the effect of butorphanol in the prevention of shivering during abdominal surgery under epidural anesthesia.Methods Ninety patients undergoing abdominal surgery under epidural anesthesia were randomly divided into three groups：butorphanol group（group B）,pethidine group（group D） and the control group（normal saline,group C）.The group B was given intravenous injection of butorphanol at a dose of 1 mg/5 mL,the group D was given intravenous injection of pethidine at a dose of 15～30 mg/5 mL and the group C was given intravenous injection of 5 mL normal saline.The preventive effects of shivering,changes of vital signs and adverse reactions were recorded at 5,15,30 min after administration for comparing with group C ascontrol.Results The effectiveness of shivering prevention in the group B and D within 5 min after administration were 96.67%and 86.67%respectively,without significant difference between the two groups.But comparing one of these two groups with the control group showed significant difference（P 0.05）.The changes of vital signs before and after administration in the group B and C had no significant difference,the changes in the group D showed significant difference compared with before administration（P 0.05）.The group B was prone to sleepiness than the group D（P 0.05）.The group D was more likely to nausea and vomiting than the group B（P 0.05）.Allthree groups had no respiratory depression.Conclusion Butorphanol and pethidine both have significant effects on the prevention of shivering in abdominal surgery under epidural anesthesia.Butorphanol is superior to pethidine in the curative effects without significant difference.