昂丹西酮复合曲马多用于腰硬联合麻醉后寒颤的临床观察

目的探讨昂丹西酮复合曲马多用于腰硬联合麻醉后寒颤的临床效果。方法ASAⅠ-Ⅱ级择期在腰硬联合麻醉下行下腹部或下肢手术患者100例，随机分为4组，生理盐水组（N组），昂丹西酮组（0组），曲马多组（T组），昂丹西酮复合曲马多组（O＋T组）。N组静脉注射生理盐水10mL，O组静脉注射昂丹西酮4 mg，T组静脉注射曲马多1mg／kg，O＋T组是在O组的基础上患者行麻醉穿刺后于平卧位后静脉注射曲马多1mg／kg。观察术中寒颤和恶心、呕吐等的发生情况。结果寒颤发生率N组与O组、T组、O＋T组比较有显著性差异（P〈0．01），恶心、呕吐发生率O＋T组、O组与N组、T组比较有显著性差异（P〈0．05）。结论麻醉前静脉注射昂丹西酮4mg，平卧位后静脉注射曲马多1mg，kg，对麻醉后寒颤起到很好地预防和治疗作用，并大大降低了恶心、呕吐的发生率。

Clinical Observation of Ondansetron Compound Tramadol for Combined Spinal-Epidural Anesthesia after Shivering

Objective To discuss the best drug treatment programmes of combined spinal-epidural anesthesia after shivering. Methods ASA Ⅰ- Ⅱ selective combined spinal-epidural anesthesia in the lower abdomen or downlink 100 patients with lower extremity surgery were randomly divided into four groups： NS group （group N）, Ondansetron group （group O）, tramadol group （group T）, Ondansetron compound tramadol group （group O＋T）. Group N：saline 5mL was injected viavein, Group O：Ondansetron 4mg was injected into viavein, Group T：tramadol 1mg/kg was injected into viavein. Group O＋T is in group O of foundation. After anesthesia patients with puncture and the supine position, tramadol 1mg/kg was injected into viavein, to observe shivering, and nausea and vomiting in case in the operation. Results The incidence rate of shivering N group with O group, T group, the O＋T group comparison had the significant difference.The incidence of nausea and vomitting in O＋T group,O group with N group, T group comparison had the significant difference. Conclusion Injection viavein with Ondansetron 4mg before anaesthesia, tramadol 1mg/kg was injected viavein. Right after anesthesia shivering play a very good role in the prevention and treatment and greatly reduce the incidence of nausea and vomiting.