【摘要】 目的:探讨同哌替啶和曲马多比较,格拉斯琼预防全麻后寒战的临床效果。方法:120例ASAI～II级,在全麻下拟行择期手术患者,随机分为四组,每组30例:T组(曲马多1mg/kg),G组(格拉斯琼40μg/kg),M组(哌替啶0.4mg/kg)和P组(0.9%生理盐水)。各组药物在手术结束时通过静脉给予。记录术后寒战评分和麻醉恢复时间及镇静程度。结果:同对照组比较,格拉斯琼明显减少麻醉后寒战的发生(P<0.01),但同哌替啶和曲马多组比较无统计学差异(P>0.05)。哌替啶组和曲马多组的麻醉恢复时间(20.58±3.56和16.45±4.13min)较对照组(12.61±3.31min)和格拉斯琼组(13.58±3.41min)明显延长(P<0.05)。结论:使用40μg/kg格拉司琼同使用曲马多1mg/kg和哌替啶0.4mg/kg一样可有效地预防麻醉后寒战。更多还原

【Abstract】 Objective:To evaluate the efficacy of granisetron in comparison with meperidine and tramadol in preventing postanesthetic shivering.Methods:120 ASA I and II patients undergoing elective surgery under standardized general anesthesia were included.At the end of surgery,patients were randomly assigned to one of four groups (each group n = 30) using a double-blinded protocol.Group T received 1 mg/kg tramadol,group G received 40 μg/kg granisetron (an antiemetic dose),group M received 0.4 mg/kg meperidine,and group P received saline 0.9% as placebo.Shivering was graded according to the following:0 = no shivering;1 = piloerection,peripheral vasoconstriction or peripheral cyanosis without other cause;2 = visible muscular activity confined to one muscle group;3 = visible muscular activity in more than one muscle group;and 4 = gross muscular activity involving the entire body.The emergence time from anesthesia,defined as the time between withdrawal of isoflurane and tracheal extubation,was documented.Results:The number of patients with observable shivering was 19 in group P,nine in group G,seven in group T and six in group M.Granisetron significantly reduced the incidence of shivering in comparison with placebo (P=0.013).Although the frequency of shivering was higher with granisetron in comparison to tramadol and meperidine,it was not statistically significant (P>0.05).The number of patients with a shivering score of 2,3 and 4 was significantly higher in group P compared with the other groups (P= 0.001).Both meperidine and tramadol caused a significantly prolonged emergence time (20.58 ± 3.56 and 16.45 ± 4.13 minutes,respectively) as opposed to granisetron (13.58 ± 3.41 minutes) and placebo (12.61 ± 3.31 minutes).Conclusion:The prophylactic use of granisetron 40 μg/kg is as effective as meperidine (0.4 mg/kg) and tramadol (0.1 mg/kg) in preventing postanesthetic shivering without prolonging the emergence time from anesthesia更多还原