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蛛网膜下腔注射曲马多对预防剖宫产患者术中寒战的观察 被引量:1

Clinical observation on the preventive effect against patient's shivering during casearean section by injecting tramadol into the subarachnoid space
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摘要 目的观察蛛网膜下腔注射曲马多预防剖宫产患者术中寒战的效果.方法选择剖宫产手术患者80例,ASA分级Ⅰ~Ⅱ级,随机分成对照组(A组)和曲马多组(B组),每组40例.腰硬联合麻醉,40s内匀速向蛛网膜下腔注入药液.A组:0.5%布比卡因1.8ml,B组:0.5%布比卡因1.8ml+曲马多0.3~0.4mg/kg,观察术中寒战分级、恶心呕吐发生率.结果B组术中寒战发生率较A组低(P<0.01),同时,寒战程度也较轻.B组术中恶心呕吐发生率为90%,较A组高(P<0.01).结论小剂量曲马多(0.3~0.4mg/kg)注入蛛网膜下腔可以用于腰麻下剖宫产术中寒战的预防,但增加恶心呕吐的发生率. Objective To observe the preventive effect against patient's shivering during caesarean section by injecting tramadol into the subarachnoid space.Methods Eighty ASA Ⅰ-Ⅱ patients (age range 21 - 29 yr), weighting 65 - 85 kg who received the casesarean section. The patients were divided into 2 groups randomly ( n = 40 each) ,group A (control group) and group B(tramadol group). Using the combined spinal and epdural anesthesia (SCEA), and choosing L3-4 as the dural puncture pot. After successful dural puncture, the different medicines were injected: group A with 0.5% bupivacaine 1.8 ml and group B with 0.5% bupivacaine 1.8 ml mixed tramadol 0.3 - 0. 4 mg/kg injected into the subarachnoid space, the incidences of shivering, nausea and vomiting were observed. Results The incidence and the degree of shivering in group B were less and lighter than that in group A ( P 〈 0. 01 ). The incidence of nausea and vomiting in group B (90%) was significantly higher than that of group A ( P 〈 0.01 ). Conclusion Low-dose tramadol (0.3 - 0. 4 mg/kg) administered in subarachnoid space during caesarean section may prevent the occurrence of shivering, however, the complication of nausea and vomiting may increase comparatively.
出处 《河北医药》 CAS 2006年第4期266-267,共2页 Hebei Medical Journal
关键词 曲马多 蛛网膜下腔 剖宫产 寒战 tramadol subarachnoid space caesarean section shivering
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  • 1De Witte J,Deloof T,De Veylder J,et al.Tramadol in the treatment of postanaesthetic shivering.Acta Anaesthesiol Scand,1997,41:506-510.
  • 2Wrench IJ.Singh P,Dennis AR,et al.The minimum effective doses of pethidine and doxapram in treatment of post-anaesthetic shivering.Anaethesia,1997,52:32-36.
  • 3曹建平,徐建国.曲马多和哌替啶用于全麻后寒战的预防[J].中华麻醉学杂志,2003,23(3):220-221. 被引量:46
  • 4De Witte J,Rietman Gw,Vandenbroucke G,et al.Post-operative effects of tramadol administered at wound closure.Eur J Anaesthesiol,1998,15:190-195.

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