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不同剂量羟考酮治疗腰-硬联合麻醉剖宫产产妇寒战的疗效分析

  • 摘要: 目的:观察不同剂量羟考酮对产妇剖宫产手术腰硬联合麻醉后寒战反应的治疗效果。方法:选择择期在腰硬联合麻醉下行剖宫产手术中出现寒战的产妇100例,ASA Ⅰ~Ⅱ级。采用随机数字表法将产妇分为5组(n=20):0.9%氯化钠液(C)组,曲马多1 mg/kg(T)组,羟考酮20 μg/kg(O1)组、40 μg/kg (O2)组、80 μg/kg (O3)组。胎儿娩出后缓慢静脉注射相应药物。记录给药后即刻(T1)和给药后5 min(T2)、10 min(T3)、15 min(T4)、20 min(T5)、30 min(T6)时血流动力学的变化,患者寒战情况及不良反应的发生情况。结果:各组患者寒战严重程度差异无统计学意义;T组、O2组、O3组寒战治愈率明显高于C组(90%、50%、75% vs 15%,P<0.05),T组与O3组相比差异无统计学意义。T1时寒战的缓解率在T组、O3组差异无统计学意义(80% vs 60%)。T组恶心呕吐的发生率高于O3组(P<0.05)。与其余4组比较,O3组产妇术后镇痛的满意度最高(P<0.05)。结论:静脉给予80 μg/kg羟考酮能够迅速有效治疗脊麻后寒战反应,并提高产妇术后镇痛的满意度。

     

    Abstract: Objective:To observe the clinical efficacy of the different dose of oxycodone on shivering in caesarean section after combinedspinal epidural anesthesia(CSEA). Methods:One hundred puerperae, ASA physical status Ⅰ-Ⅱ, scheduled for elective cesarean delivery under CESA were investigated. Puerperae who developed shivering after CSEA were randomly divided into five groups(n=20 each) using a random number table: saline (Group C), tramadol 1 mg/kg(Group T),oxycodone 20,40, and 80 μg/kg groups(Group O1,O2, and O3). All drugs were infused as a slow intravenous 〖BP(〗bolus by a blinded investigator 〖BP)〗after fetal delivery. The shivering intensity, the changes of hemodynamic and adverse reaction in right after medication (T1), after medication in 5 min (T2), 10 min(T3), 15 min(T4), 20 min(T5), 30 min(T6)were recorded. Results:There was no statistical significance of the shivering intensity found in each group. The shivering controlled rate in Group T, Group O2, and Group O3 were significantly higher than Group C (90%, 50%, 75% vs15%,P<0.05), and no statistical significance was found in Group T and Group O3 . No statistical significance of shivering controlled in T1 was found in Group T and that in Group O3 (80% vs 60%). The incidence of nausea and vomiting in Group T was higher than that in Group O3 (P<0.05). Compared with other four groups, the satisfaction rate of postoperative analgesia in Group O3 was the highest (P<0.05). Conclusions:Oxycodone 80 μg/kg produced a rapid and potent antishivering effect, which can improve the satisfaction rate of postoperative analgesia.

     

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