曲马多治疗椎管内麻醉后寒战60例分析(1)
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【摘要】 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1 mg/kg(组Ⅰ)、1.5 mg/kg(组Ⅱ)、2 mg/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1~2 mg/kg后均于1~3 min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。
【关键词】
寒战；曲马多；麻醉；椎管内
Effect of Tramadol hydrochloride on shivering after intravertebrial anesthesia in 60 cases
SHANG Ying-chun,WU Jing,CHEN Xiang-yin,et al.
Department of Anesthesiology,The First People’s Hospital of Laohekou city,Hubie 441800,China
【Abstract】 ObjectiveTo observe the efficacy and safety of Tramadol hydrochloride in shivering treatment after intravertebrial anesthesia. MethodsSixty ASAⅠ~Ⅲ patients scheduled for abdominal orlower 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. ResultsShivering 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.ConclusionThetreatment of tramadol hydrochloride in shivering after intravertebrial anesthesia are effective,when used in shivering treatment in elderly or outpatients is better than other opiums.
【Key words】
Shivering;Tramadot;Anesthesia;Intravertebral
寒战是临床围麻醉期的多见并发症，不仅会使机体耗氧量增高、增加患者的恐惧感，而且还会影响手术的操作。既往曾将哌替啶、氯丙嗪等用以治疗，均取得一定疗效，但这对于老年、高危患者等存在着呼吸、循环抑制的危险性。本文旨在探讨利用盐酸曲马多治疗椎管内麻醉后寒战的安全性和有效性。
1 资料与方法
1.1 一般资料 选择ASAⅠ~Ⅲ级于椎管内麻醉下行下腹部、下肢手术而出现寒战的患者60例，年龄14~89岁，平均(43±17)岁，按静脉注射曲马多的剂量随机分为3组：1 mg/kg(组Ⅰ)、1.5 mg/kg(组Ⅱ)、2 mg/kg(组Ⅲ) ......
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