【摘要】 目的探讨不同速率输注右美托咪定预防腰麻后寒战的临床疗效。方法选择腰麻下手术患者100例,ASA分级Ⅰ、Ⅱ级,根据不同的右美托咪定输注速率将患者随机分为4组:D1组[0.2 g/(kg.h)]、D2组[0.4 g/(kg.h)]、D3组[0.6 g/(kg.h)]和对照组。记录4组患者术中生命体征变化、预防寒战的效果和不良反应发生情况。结果 D1、D2、D3组患者在T1、T2、T3时的HR较同组T0时显著下降(P<0.05),且D3组下降最为明显,部分患者需要阿托品干预;对照组患者T1、T2、T3的HR与D1、D2、D3组比较差异有统计学意义(P<0.05)。与对照组比较,D1、D2、D3组寒战发生率显著降低(P<0.05),且3组组内比较差异无统计学意义(P>0.05);D1、D2、D3组患者心动过缓的发生率明显高于对照组,且以D3组最为明显,阿托品的使用率最高,患者嗜睡情况也明显增多(P<0.05)。结论右美托咪定能有效预防腰麻后寒战的发生,以0.2~0.4μg/(kg.h)的静注速率维持较佳。更多还原

【Abstract】 Objective To observe the effects of different rates of dexmedetomidine infusion on the prevention of shivering in patients undergoing spinal anesthesia.Methods A total of 100 patients undergoing spinal anesthesia with ASA Ⅰ-Ⅱ were randomly allocated into 4 groups(25 each) according to different dexmedetomidine infusion rates: group D1[0.2 g/(kg·h)],group D2[0.4 g/(kg·h)],group D3[0.6 g/(kg·h)] and group S(control group).The changes of vital signs and shivering were recorded during the operation.Results The heart rates(HR) of patients in D1,D2 and D3 at T1,T2 and T3 decreased significantly compared with those at T0(P<0.05).The decline was most remarkable in D3.Some patients received Aspirin for medical intervention.Compared with those in D1,D2 and D3,the HRs of the control group at T1,T2 and T3 showed statistically significant difference(P>0.05).Compared with the control group,the incidence rates of shivering of D1,D2 and D3 dropped significantly(P<0.05).The incidence rate of slower HRs in D1,D2 and D3 were significantly higher than that in the control group.That was most remarkable in D3 with most frequent usage of aspirin.More patients with drowsiness were recorded(P<0.05).Conclusion The best infusion rate of dexmedetomidine for preventing shivering with spinal anesthesia is 0.2-0.4 g/(kg·h).更多还原