摘要
目的:探讨亚麻醉(催眠)剂量丙泊酚联合曲马多静注对椎管内麻醉后患者寒战的止颤效果及恶心呕吐的发生率以及安全性。方法:120例ASAⅠ级或Ⅱ级椎管内麻醉后发生术中或术后早期寒战的下腹部或下肢手术患者,随机分成3组。分别为曲马多联合丙泊酚0.5 mg/kg组(A组)及联合丙泊酚0.25 mg/kg组(B组)、曲马多组(C组)。患者发生寒战时,均给予曲马多1 mg/kg,其中A组与B组再同时分别静推丙泊酚0.5 mg/kg或0.25 mg/kg。观察并记录三组患者用药前寒战分级、用药后寒战缓解程度、恶心呕吐发生率、镇静情况及其它不良反应。监测患者给药前后平均动脉压(MAP)、心率(HR)、脉搏血氧饱和度(Sp O2)。结果:用药后组内比较三组寒战分级均显著降低(P<0.01),其中A、B和C组寒战完全停止的病人比例分别为100%、95%和92.5%,组间疗效比较无统计学差异。三组患者MAP、HR、Sp O2组内比较均无统计学差异(P>0.05),均未发生镇静过度或呼吸抑制。与C组比较(30%),A组(2.5%)和B组(15%)呕吐发生率明显较低(P<0.05)。结论:小剂量丙泊酚(0.5 mg/kg)联合曲马多1 mg/kg治疗椎管内麻醉后患者寒战安全有效,并能显著降低恶心呕吐的发生。
AIM： To evaluate the effect and safety of low-dose propofol in preventing nausea and vomiting when adjunct to tramadol for treating shivering after intrathecal anesthesia. METHODS： 120（ ASAⅠ-Ⅱ） patients encountered shivering after intrathecal anesthesia requiring tramadol treatment were randomly assigned to three even groups,treated with tramadol 1 mg / kg alone（ group C）,tramadol adjunct with propofol 0. 5 mg / kg（ group A） or 0. 25 mg / kg（ group B）. The anti-shivering effect of the treatment were evaluated and the side-effects including nausea vomiting or sedation were compared.RESULTS： All groups were very effective and terminated shivering in 92. 5%,95% or 100% of the patients in group C,group B or group A respectively,which were not significantly different among groups（ P〈0. 05）. MAP,HR,and Sp O2 were stable after the treatment and were not significantly different among groups（ P〈0. 05）. Neither over sedation nor respiratory depression ocurred to any patient. However,the incidence of nausea and vomiting was significantly reduced in group A（ 2. 5%） and group B（ 15%） comparing with that in group C（ 30%）（ P〈0. 01 or 0. 05）. CONCLUSION： Adjunction with low-dose（ 0. 5 mg / kg） propofol was effective and safe to prevent nausea and vomiting caused by tramadol when treating shivering after intrathecal anesthesia.
出处
《中国临床药理学与治疗学》
CAS
CSCD
2015年第7期793-796,共4页
Chinese Journal of Clinical Pharmacology and Therapeutics
关键词
丙泊酚
曲马多
椎管内麻醉
寒战
propofol
tramadol
intrathecal anesthesia
shivering
作者简介
王磊，男，副主任医师，研究方向：临床麻醉与药理。Tel：13615739338E．mail：13615739338@163．com
周大春，通信作者，男，硕士，主任医师，硕士生导师，研究方向：临床麻醉与药理。Tel：13588708510 E-mail：zhoudc86@163．com
